WEST COUNTY HEALTH CENTERS, INC. (NPI# 1598768962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598768962 |
| Entity Type | Organization |
| Organization Name | WEST COUNTY HEALTH CENTERS, INC. |
| Other Organization Name | OCCIDENTAL AREA HEALTH CENTER |
| Practice Address |
3802 Main Street Occidental CA 95464 |
| Mailing Address |
Po Box 1449 Guerneville CA 95446-1449 |
| Practice Telephone | 7078742444 |
| Practice Fax Number | 7078741664 |
| Mailing Telephone | 7078742444 |
| Mailing Fax Number | 7078741664 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2008-01-23 |
| Authorized Official Name | MISS TARI M WALLACE (BILLING DIRECTOR) |
| Authorized Official Telephone | 7078695977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD PIN | ZZZ23666Z | 01 |
| CA | FPACT | HAP03899G | 01 |
| CA | FHC03899G | 05 |
| Other Name | Type Code |
|---|---|
| Occidental Area Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1356344758 | West County Health Centers, Inc. | Clinic/Center | 16319 Third Street, Guerneville, CA 95446 | 2005-05-31 |
| 1215488705 | West County Health Centers, Inc. | Clinic/Center | 16312 Third St, Guerneville, CA 95446 | 2016-10-19 |
| 1861809501 | West County Health Centers, Inc. | Clinic/Center | 652 Petaluma Ave, Sebastopol, CA 95472-4256 | 2014-07-15 |
| 1659630036 | West County Health Centers, Inc. | Clinic/Center | 6550 Front Street, Forestville, CA 95436-0000 | 2012-05-07 |
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
| Street Address |
3802 MAIN STREET |
| City | OCCIDENTAL |
| State | CA |
| Zip Code | 95464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718413 | Kathleen O'brien | Social Worker | 3802 Main Street, Occidental, CA 95465 | 2005-05-31 |
| 1154659373 | Molly Rebecca Kirkconnell | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2009-11-28 |
| 1609878917 | Trina Bowen | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1427050731 | Victoria Davis | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-06-01 |
| 1700889128 | Uyen T Ly | Family Medicine | 3802 Main Street, Occidental, CA 95465 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629512512 | Cpm Consulting, LLC | Technician, Health Information | 3084 Manzanita Rd., Nice, CA 95464 | 2016-12-12 |
| 1376991760 | Baylee Sperber | Massage Therapist | 3508 E. Highway 20, Nice, CA 95464 | 2016-05-26 |
| 1891069084 | Cynthia Michelle Gananian-jackson | Registered Nurse | 3166 Lakeview Dr., Nice, CA 95464 | 2012-03-06 |
| 1396744702 | Nice Fire and Rescue Department | Ambulance | 3708 Manzanita Dr, Nice, CA 95464 | 2005-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922571611 | Cynthia Ann Kane Hyman | Registered Nurse | 2598 Joy Rd, Occidental, CA 95465-9262 | 2019-01-06 |
| 1831604669 | Theresa Sheppard Alexander | Marriage & Family Therapist | 3944 Harmony Village Circle, Occidental, CA 95465 | 2017-12-01 |
| 1578946984 | Karen Prosen | Marriage & Family Therapist | 15301 Coleman Valley Rd, Bohemian Hwy, Occidental, CA 95465-9373 | 2015-07-02 |
| 1922481431 | Jennifer Elizabeth Nagel | Acupuncturist | 3840 Doris Murphy Ct, Occidental, CA 95465-9130 | 2015-07-01 |
| 1053540591 | Dianna D, Evans | Marriage & Family Therapist | 5187 Occidental Camp Meeker Road, Occidental, CA 95465 | 2009-07-06 |
| 1902019524 | Miriam Redstone | Social Worker | 18200 Willow Creek Road, Occidental, CA 95465 | 2007-05-08 |
| 1629113717 | Shari Liggett Kovner | Nurse Practitioner | 3802 Main St., Occidental, CA 95465 | 2007-02-20 |
| 1720192487 | Wendy Wiley | Physician Assistant | 3802 Main St, Occidental, CA 95465 | 2006-08-19 |
| 1831107556 | Steven Louis Mcneal | Dentist | 4066 Bohemian Hwy, Occidental, CA 95465 | 2006-08-05 |
| 1093718413 | Kathleen O'brien | Social Worker | 3802 Main Street, Occidental, CA 95465 | 2005-05-31 |
| Find all providers in OCCIDENTAL | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| City | OCCIDENTAL |
| Zip Code | 95464 |
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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.