SRM ALLIANCE HOSPITAL SERVICES (NPI# 1790770188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790770188 |
| Entity Type | Organization |
| Organization Name | SRM ALLIANCE HOSPITAL SERVICES |
| Other Organization Name | HOSPICE OF PETALUMA |
| Practice Address |
416 Payran St Petaluma CA 94952-5907 |
| Practice Telephone | 7077786242 |
| Practice Fax Number | 7077780144 |
| Mailing Telephone | 7077786242 |
| Mailing Fax Number | 7077780144 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2009-11-05 |
| Authorized Official Name | JUDITH C RYDER (DIRECTOR) |
| Authorized Official Telephone | 7077786242 |
| Is Organization Subpart | Y |
| Parent Organization Name | SANTA ROSA MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315D00000X | Hospice, Inpatient | 100000735 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | H01557G | 05 |
| Other Name | Type Code |
|---|---|
| Hospice of Petaluma | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235162645 | Srm Alliance Hospital Services | General Acute Care Hospital | 400 N. Mcdowell Blvd, Petaluma, CA 94954 | 2006-07-09 |
| 1770703886 | Srm Alliance Hospital Services | Skilled Nursing Facility | 400 N Mcdowell Blvd, Petaluma, CA 94954-2339 | 2007-04-30 |
| 1962536912 | Srm Alliance Hospital Services | General Acute Care Hospital | 400 N Mcdowell Blvd, Petaluma, CA 94954-2339 | 2007-03-14 |
| Street Address |
416 PAYRAN ST |
| City | PETALUMA |
| State | CA |
| Zip Code | 94952-5907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467919050 | Adrienne C Bragdon | Counselor | 416 Payran St, Petaluma, CA 94952-5907 | 2019-03-01 |
| 1174065809 | St. Joseph Home Care Network | Hospice Care, Community Based | 416 Payran St, Petaluma, CA 94952-5907 | 2016-11-11 |
| 1184681165 | Scott W. Eberle | Family Medicine | 416 Payran St, Petaluma, CA 94952-5907 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
| 1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
| 1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
| 1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
| 1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
| 1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
| 1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
| 1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
| 1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
| 1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
| Find all providers in zip 94952 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381236 | Malibu Hospice Inc | Hospice, Inpatient | 4301 Alonzo Ave, Encino, CA 91316-4308 | 2020-09-18 |
| 1881209039 | Hospice of Love and Care Group Inc | Hospice, Inpatient | 18344 Oxnard St Ste 208, Tarzana, CA 91356-6777 | 2020-09-14 |
| 1154957835 | Armani Oganyan | Hospice, Inpatient | 10523 Burbank Blvd Ste 104, North Hollywood, CA 91601-2235 | 2020-03-13 |
| 1235789462 | Sierra Care At The Lake,llc | Hospice, Inpatient | 33425 Globe Dr, Springville, CA 93265 | 2019-09-19 |
| 1851893291 | Heritage Crossing Fresno Inc. | Hospice, Inpatient | 2792 E Alluvial Ave, Clovis, CA 93611-9104 | 2018-03-01 |
| 1447761820 | Trusted Hospice Care | Hospice, Inpatient | 17915 Ventura Blvd Ste 233, Encino, CA 91316-4815 | 2017-10-12 |
| 1548631906 | United Hospice, Inc. | Hospice, Inpatient | 14638 Rodeo Dr, Victorville, CA 92395-4133 | 2015-10-12 |
| 1396131041 | Hdmc Holdings, LLC | Hospice, Inpatient | 6601 White Feather Rd Ste A-5, Joshua Tree, CA 92252-6607 | 2015-04-09 |
| 1073908315 | Empacare Homecare | Hospice, Inpatient | 7231 Boulder Ave., Ste 197, Highland, CA 92346 | 2015-04-03 |
| 1053714972 | Active Angel Caregiver Agency | Hospice, Inpatient | 13605 Heather Way, Hawthorne, CA 90250-6474 | 2014-10-06 |
| 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.