HUMBOLDT FOOT & ANKLE PC (NPI# 1508422015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508422015 |
| Entity Type | Organization |
| Organization Name | HUMBOLDT FOOT & ANKLE PC |
| Practice Address |
1730 Main St Fortuna CA 95540-2467 |
| Practice Telephone | 7077255223 |
| Mailing Telephone | 7077255223 |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-05-10 |
| Authorized Official Name | LISA HOUSEWORTH (PRACTICE MANAGER) |
| Authorized Official Telephone | 7077255223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Humboldt Foot and Ankle | Doing Business As Name - Organization |
| Street Address |
1730 MAIN ST |
| City | FORTUNA |
| State | CA |
| Zip Code | 95540-2467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437184025 | Neil R Kelley | Podiatrist | 1730 Main St, Fortuna, CA 95540-2451 | 2006-07-11 |
| 1073783163 | Brett Michael Wonenberg | Dentist | 1730 Main St, Suite A, Fortuna, CA 95540-2451 | 2008-03-05 |
| 1851590012 | Ali Deyhim | Podiatrist | 1730 Main St, Fortuna, CA 95540 | 2007-07-17 |
| 1154452324 | Kerisa Sue Elloway | Dentist | 1730 Main St, Suite A, Fortuna, CA 95540-2451 | 2007-03-08 |
| 1003986779 | Family Foot Care Specialist Podiatry Center | Durable Medical Equipment & Medical Supplies | 1730 Main St, Fortuna, CA 95540-2451 | 2006-11-09 |
| 1699791160 | Family Foot Care Specialists Podiatry Center Inc | Durable Medical Equipment & Medical Supplies | 1730 Main St, Fortuna, CA 95540-2467 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234787 | Remi Vista, Inc. | Community/Behavioral Health | 3000 Newburg, Fortuna, CA 95540 | 2020-01-21 |
| 1144867474 | Paula-marie Schneider | Registered Nurse | 3750 Rohnerville Rd., Fortuna, CA 95540 | 2019-12-05 |
| 1609265537 | Nancy Stinson Lollich | Physical Therapy Assistant | 2321 Newburg Road, Fortuna Rehabilitation and Wellness, Fortuna, CA 95540 | 2015-01-15 |
| 1730438151 | Heber House Inc. Dba Dermatology Center | Dermatology | 2404 Newburg Rd., Fortuna, CA 95540 | 2012-08-30 |
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1205181526 | Constance Mitchell | Registered Nurse | Redwood Pediatrics, 3305 Renner Dr, Fortuna, CA 95540 | 2012-07-24 |
| 1730457177 | Joy Nadine Frasier | Counselor | 220 Wilson Ln., Fortuna, CA 95540 | 2011-12-13 |
| 1063791713 | Gardenside Eldercare, LLC | Residential Treatment Facility, Physical Disabilities | 529 9th Street, Fortuna, CA 95540 | 2011-08-12 |
| 1093025173 | Sheri A Jewett | Massage Therapist | 2655 Virginia Court, Fortuna, CA 95540 | 2010-10-07 |
| 1134371339 | Mariana Van Der Merwe | Pharmacist | 725 South Boulevard, Rite Aid Pharmacy, Fortuna, CA 95540 | 2008-10-21 |
| Find all providers in zip 95540 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851590012 | Ali Deyhim | Podiatrist | 1730 Main St, Fortuna, CA 95540 | 2007-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528726 | Millennium Foot and Ankle Institute PC | Podiatrist | 26235 Ravenhill Rd, Santa Clarita, CA 91387-4046 | 2020-11-02 |
| 1861008054 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 5471 La Palma Ave Ste 106, La Palma, CA 90623-1792 | 2020-09-22 |
| 1174139356 | Ronald J Belczyk, Dpm Inc. | Podiatrist | 4911 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1746 | 2020-09-22 |
| 1093327231 | Upperline Healthcare California PC | Podiatrist | 2131 San Joaquin Hills Rd, Newport Beach, CA 92660-6507 | 2020-08-19 |
| 1841815545 | Kenny Au Quach | Podiatrist | 17100 Euclid St # 4004, Fountain Valley, CA 92708-4004 | 2020-06-09 |
| 1417579129 | Central California Leg, Foot, and Ankle Center, Inc. | Podiatrist | 11325 Park Square Dr Apt D204, Bakersfield, CA 93311-8854 | 2020-05-15 |
| 1487282109 | Laura Y Lee, Dpm Inc | Podiatrist | 5525 Forestwood Dr, Sacramento, CA 95842-2128 | 2020-03-29 |
| 1780211458 | Dupontdpm Inc. | Podiatrist | 651 1st St W Ste C, Sonoma, CA 95476-7046 | 2020-03-24 |
| 1659903722 | Bay Area Foot Care, Inc | Podiatrist | 5924 Stoneridge Dr Ste 102, Pleasanton, CA 94588-2750 | 2020-02-06 |
| 1780215210 | Albert Elhiani Dpm Inc | Podiatrist | 9340 W Pico Blvd Ste 2, Los Angeles, CA 90035-1255 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.