SANTA ROSA COMMUNITY HEALTH CENTERS (NPI# 1568665073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568665073 |
| Entity Type | Organization |
| Organization Name | SANTA ROSA COMMUNITY HEALTH CENTERS |
| Other Organization Name | SOUTHWEST COMMUNITY HEALTH CENTER |
| Practice Address |
599 Bellevue Ave Santa Rosa CA 95407-7713 |
| Practice Telephone | 7075472220 |
| Practice Fax Number | 7073033182 |
| Mailing Telephone | 7075472220 |
| Mailing Fax Number | 7073033182 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-11-15 |
| Authorized Official Name | MR. HAROLD BROCKMAN (CFO) |
| Authorized Official Telephone | 7075838839 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
110000489 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FAMILY PACT ID | HAP70937F | 01 |
| Other Name | Type Code |
|---|---|
| Southwest Community Health Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962613349 | Santa Rosa Community Health Centers | Clinic/Center | 3569 Round Barn Circle, Santa Rosa, CA 95403-5781 | 2007-05-25 |
| 1871651273 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2006-12-05 |
| 1689742215 | Santa Rosa Community Health Centers | Clinic/Center | 684 Benecia Drive, Santa Rosa, CA 95409-3058 | 2006-12-01 |
| 1780195255 | Santa Rosa Community Health Centers | Clinic/Center | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2017-10-23 |
| 1518345511 | Santa Rosa Community Health Centers | Clinic/Center | 3333 Chanate Rd, Santa Rosa, CA 95404-1707 | 2015-05-11 |
| 1255600037 | Santa Rosa Community Health Centers | Community/Behavioral Health | 3569 Round Barn Cir, Santa Rosa, CA 95403-5781 | 2011-12-22 |
| 1184909103 | Santa Rosa Community Health Centers | Clinic/Center | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2011-10-21 |
| 1558512624 | Santa Rosa Community Health Centers | Clinic/Center | 711 Stony Point Rd Ste 17, Santa Rosa, CA 95407-6848 | 2008-10-07 |
| 1114120623 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
| 1578766085 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Ct Ste B, Santa Rosa, CA 95407-6793 | 2007-06-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SANTA ROSA COMMUNITY HEALTH CENTERS | 3569 Round Barn Cir, Santa Rosa, CA 95403-5781 |
| Street Address |
599 BELLEVUE AVE |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-7713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871651273 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386960862 | Su Clinica Familiar | Clinic/Center | Hwy 107 and La Feria Avenue, Santa Rosa, TX 78593-0226 | 2010-04-09 |
| 1871651273 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2006-12-05 |
| 1245739697 | Santa Rosa Community Health Center | Clinic/Center | 3883 Airway Dr Ste 202, Santa Rosa, CA 95403-1671 | 2018-02-12 |
| 1780195255 | Santa Rosa Community Health Centers | Clinic/Center | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2017-10-23 |
| 1518345511 | Santa Rosa Community Health Centers | Clinic/Center | 3333 Chanate Rd, Santa Rosa, CA 95404-1707 | 2015-05-11 |
| 1184909103 | Santa Rosa Community Health Centers | Clinic/Center | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2011-10-21 |
| 1558512624 | Santa Rosa Community Health Centers | Clinic/Center | 711 Stony Point Rd Ste 17, Santa Rosa, CA 95407-6848 | 2008-10-07 |
| 1114120623 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
| 1578766085 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Ct Ste B, Santa Rosa, CA 95407-6793 | 2007-06-11 |
| 1487857991 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
Please comment or provide details below to improve the information on SANTA ROSA COMMUNITY HEALTH CENTERS.
| 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.