SANTA ROSA COMMUNITY HEALTH CENTERS (NPI# 1962613349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962613349 |
Entity Type | Organization |
Organization Name | SANTA ROSA COMMUNITY HEALTH CENTERS |
Other Organization Name | SOUTHWEST COMMUNITY HEALTH CENTER |
Practice Address |
3569 Round Barn Circle Santa Rosa CA 95403-5781 |
Practice Telephone | 7073033600 |
Practice Fax Number | 7073063635 |
Mailing Telephone | 7073033600 |
Mailing Fax Number | 7073033635 |
Enumeration Date | 2007-05-25 |
Last Update Date | 2012-11-16 |
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 |
---|---|---|---|---|---|
N | 261Q00000X | Clinic/Center | 550000087 | CA | Ambulatory Health Care Facilities |
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550000087 | CA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | FAMILY PACT ID | HAP71099F | 01 |
CA | HAP71099F | 05 |
Other Name | Type Code |
---|---|
Southwest Community Health Center | Former Legal Business Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1487857991 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, 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 |
3569 ROUND BARN CIRCLE |
City | SANTA ROSA |
State | CA |
Zip Code | 95403-5781 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
Find all providers in zip 95403 |
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 | 95403 |
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.