MEDICARE: HOSPICE OF THE FOOTHILLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	251G00000X	Community Based Hospice Care Agency	100000763	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	051629001	OTHER	CA	051629001

General Provider Information

NPI Number	:	1164527214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF THE FOOTHILLS

Provider Business Mailing Address
First Line	:	11270 ROUGH AND READY HWY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-8530
Country	:	US
Telephone Number	:	530-272-5739
Fax Number	:

Provider Business Practice Location Address
First Line	:	11270 ROUGH AND READY HWY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-8530
Country	:	US
Telephone Number	:	530-272-5739
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. HEIDI WINGO
Credential	:
Telephone Number	:	530-274-5159

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	10/02/2025

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Directions to “HOSPICE OF THE FOOTHILLS ” Practice Location

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