WELLSPACE HEALTH (NPI# 1720546724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720546724 |
| Entity Type | Organization |
| Organization Name | WELLSPACE HEALTH |
| Other Organization Name | WELLSPACE HEALTH FLORIN COMMUNITY HEALTH CENTER |
| Practice Address |
4241 Florin Rd Ste 30 Sacramento CA 95823-2535 |
| Mailing Address |
777 12th St Ste 250 Sacramento CA 95814-1929 |
| Practice Telephone | 9163912229 |
| Practice Fax Number | 9163912291 |
| Mailing Telephone | 9165505481 |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | DR. ALASDAIR JONATHAN PORTEUS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9163138413 |
| Authorized Official Credential | PHD. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WellSpace Health Florin Community Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
| 1265777692 | Wellspace Health | Clinic/Center | 631 H St, Sacramento, CA 95814 | 2012-12-12 |
| 1679819007 | Wellspace Health | Clinic/Center | 3415 Martin Luther King Jr. Blvd, Sacramento, CA 95817-3648 | 2012-12-12 |
| 1821357492 | Wellspace Health | Clinic/Center | 8231 E Stockton Blvd, Suite C, Sacramento, CA 95828-8202 | 2012-05-16 |
| 1225335581 | Wellspace Health | Clinic/Center | 5321 Stockton Blvd, Sacramento, CA 95820-5411 | 2011-02-23 |
| 1871617688 | Wellspace Health | Community/Behavioral Health | 1550 Juliesse Ave, Sacramento, CA 95817-3648 | 2007-03-19 |
| 1275687659 | Wellspace Health | Counselor | 8233 East Stockton Blvd., Suite D, Sacramento, CA 95817-3648 | 2007-01-22 |
| 1033295084 | Wellspace Health | Community/Behavioral Health | 4441 Auburn Blvd, Suite E, Sacramento, CA 95841-4139 | 2006-10-31 |
| 1558446179 | Wellspace Health | Community/Behavioral Health | 4343 Williamsbourgh Drive, Sacramento, CA 95823-2006 | 2006-10-25 |
| 1144853060 | Wellspace Health | Pharmacy | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2020-02-19 |
| Street Address |
4241 FLORIN RD STE 30 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-2535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| 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 |
|---|---|---|---|---|
| 1265059182 | Elica Health Centers | Clinic/Center | 77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 | 2020-06-26 |
| 1508487653 | Health and Life Organization, Inc. (h.a.l.o.) | Clinic/Center | 7215 55th St Ste B, Sacramento, CA 95823-2601 | 2020-04-29 |
| 1073077616 | Cares Community Health | Clinic/Center | 815 S St, Sacramento, CA 95811-7064 | 2019-01-28 |
| 1982114492 | Cares Community Health | Clinic/Center | 1442 Ethan Way Ste 100, Sacramento, CA 95825-2232 | 2017-10-10 |
| 1548705874 | Elica Health Centers | Clinic/Center | 752 Revere St Unit B, Sacramento, CA 95818-2073 | 2016-12-22 |
| 1063965952 | Health for All - Revere Clinic | Clinic/Center | 752 Revere St, Unit B, Sacramento, CA 95818-2073 | 2016-07-27 |
| 1164886040 | Peach Tree Healthcare | Clinic/Center | 3810 Rosin Ct, Suite 100, Sacramento, CA 95834-1656 | 2016-04-07 |
| 1740660703 | Elica Health Centers | Clinic/Center | 1750 Wright St Ste 1, Sacramento, CA 95825-4041 | 2015-06-04 |
| 1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
| 1508284407 | Health for All - Administration | Clinic/Center | 420 I Street, Suite 7, Sacramento, CA 95814-2319 | 2014-03-29 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on WELLSPACE HEALTH.
| 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.