PETALUMA HEALTH CENTER INC NPI 1588656268

NPI Information

NPI: 1588656268
Provider Name: PETALUMA HEALTH CENTER INC

Doing Business As: PETALUMA HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1179 N MCDOWELL BLVD
PETALUMA, CA
ZIP 94954
Phone: (707) 559-7500
Get Directions

PETALUMA HEALTH CENTER INC is a federally qualified health center (fqhc) clinic center in Petaluma, CA. PETALUMA HEALTH CENTER INC NPI is 1588656268. The provider is registered as an organization entity type.
The provider Is Doing Business As Petaluma Health Center.

The provider's business location address is:

1179 N MCDOWELL BLVD
PETALUMA, CA
ZIP 94954-559
Phone: (707) 559-7500
Fax: (707) 559-7620

The provider's authorized official is Kathryn Powell .
The authorized official title is Ceo and has the following contact phone number (707) 559-7500.

The enumeration date for this NPI number is 8/18/2005 and was last updated on 7/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BCP70696F	MEDICAID	CALIFORNIA
2	HAP70696F	MEDICAID	CALIFORNIA
3	FHC70696F	MEDICAID	CALIFORNIA
4	EAP70696F	MEDICAID	CALIFORNIA
5	551879	OTHER	CALIFORNIA	MEDICARE NGS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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