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WELLSPACE HEALTH NPI 1811262348


NPI Information

NPI: 1811262348
Provider Name: WELLSPACE HEALTH
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D1102479

Address:
5 MEDICAL PLAZA DR
SUITE 170
ROSEVILLE, CA
ZIP 95661
Phone: (916) 978-1738
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WELLSPACE HEALTH is a federally qualified health center (fqhc) clinic center in Roseville, CA. WELLSPACE HEALTH NPI is 1811262348. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5 MEDICAL PLAZA DR
SUITE 170
ROSEVILLE, CA
ZIP 95661-865
Phone: (916) 978-1738
Fax: (916) 771-3377

The provider's authorized official is Alasdair Jonathan Porteus .
The authorized official title is Chief Executive Officer and has the following contact phone number (916) 737-5555.

The CLIA number assigned to this NPI record is 05D1102479 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2012 and was last updated on 3/23/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorNo
2171W00000XContractorNo
3251C00000XDay Training, Developmentally Disabled ServicesNo
4251X00000XSupports BrokerageNo
5261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
6332U00000XHome Delivered MealsNo
73747P1801XTechnicianPersonal Care AttendantNo
8385H00000XRespite CareNo
9261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.