DIGNITY HEALTH MEDICAL FOUNDATION (NPI# 1699971333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699971333 |
| Entity Type | Organization |
| Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Other Organization Name | DIGNITY HEALTH MEDICAL GROUP - DOMINICAN, A SERVICE OF DIGNITY HEALTH |
| Practice Address |
13350 Big Basin Way Boulder Creek CA 95006-9237 |
| Mailing Address |
3160 Folsom Blvd Sacramento CA 95816-5219 |
| Practice Telephone | 8313382767 |
| Practice Fax Number | 8313382767 |
| Mailing Telephone | 9167335701 |
| Mailing Fax Number | 9167333401 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2014-12-17 |
| Authorized Official Name | GEORGE LENZI (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9168512559 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BSCA | ZZZ50290Z | 01 | |
| CA | GR0091683 | 05 |
| Other Name | Type Code |
|---|---|
| Dignity Health Medical Group - Dominican, a service of Dignity Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710129275 | Dignity Health Medical Foundation | Clinic/Center | 105 Dean Way, Folsom, CA 95630-2801 | 2009-03-30 |
| 1447492905 | Dignity Health Medical Foundation | Clinic/Center | 6060 Watt Ave, North Highlands, CA 95660-4212 | 2009-03-30 |
| 1366684821 | Dignity Health Medical Foundation | Clinic/Center | 10487 White Rock Rd, Rancho Cordova, CA 95670-5530 | 2009-03-30 |
| 1558495937 | Dignity Health Medical Foundation | Clinic/Center | 7911 Laguna Blvd, Elk Grove, CA 95758-7920 | 2007-03-15 |
| 1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
| 1568989200 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-08-24 |
| 1477074474 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-06-29 |
| 1679019798 | Dignity Health Medical Foundation | Clinic/Center | 6615 Valley Hi Dr, Sacramento, CA 95823-7076 | 2017-01-12 |
| 1508222647 | Dignity Health Medical Foundation | Clinic/Center | 18406 Roscoe Blvd, Northridge, CA 91325-4107 | 2016-01-05 |
| 1376926527 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2015-07-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIGNITY HEALTH MEDICAL FOUNDATION | 3400 Data Dr, Rancho Cordova, CA 95670-7956 |
| Street Address |
13350 BIG BASIN WAY |
| City | BOULDER CREEK |
| State | CA |
| Zip Code | 95006-9237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689681496 | Steven Magee | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-08-02 |
| 1003364084 | Kathleen C Hilton | Nurse Practitioner | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2016-09-19 |
| 1932282498 | Julia Diane Crawford | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006 | 2006-10-20 |
| 1831292994 | Amrita Ghumman | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-09-06 |
| 1376646463 | Adam Yarme | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-09-06 |
| 1023110301 | John D Bergren | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-09-05 |
| 1912919309 | Western Medical Associates | Family Medicine | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-08-13 |
| 1669482444 | Joan Donato | Social Worker | 13350 Big Basin Way, Boulder Creek, CA 95006-9237 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952529133 | Keith E Johnson | Dentist | 13270 Big Basin Way, Boulder Creek, CA 95006 | 2007-04-23 |
| 1144396292 | Erin Eileen Carlson-jones | Social Worker | 1600 W. Campbell Ave., Suite 201, Campbell, CA 95006 | 2006-11-28 |
| 1386722353 | Debra Ann Woo | Dentist | 12880 Hwy 9, Boulder Creek, CA 95006 | 2006-11-01 |
| 1578643862 | Julie Anya Broder | Acupuncturist | 12704 Hwy 9, Boulder Creek, CA 95006 | 2006-10-17 |
| 1629165584 | Boulder Creek Pharmacy | Pharmacy | 13081 Central Ave, Boulder Creek, CA 95006 | 2006-10-10 |
| 1730182163 | Howard & Tibbetts Physical Therapy, Inc. | Physical Therapist | 13350 West Park Ave, Ste A2, Boulder Creek, CA 95006 | 2005-05-31 |
| 1467570697 | Christopher Ernest Mayer | Pharmacist | 13081 Central Ave, Boulder Creek, CA 95006 | 2007-03-26 |
| 1427460823 | Jordenne Rachelle | Counselor | 133 Grove St, Boulder Creek, CA 95006-8910 | 2014-05-20 |
| 1790710515 | Patrick Brendan Rogers | Chiropractor | 13266 Highway 9, Suite A, Boulder Creek, CA 95006-8913 | 2006-07-11 |
| 1508481631 | Anna Sramek | Dietitian, Registered | 515 Steller Way, Boulder Creek, CA 95006-9053 | 2020-06-15 |
| Find all providers in zip 95006 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | BOULDER CREEK |
| Zip Code | 95006 |
Please comment or provide details below to improve the information on DIGNITY HEALTH MEDICAL FOUNDATION.
| 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.