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NPI Code Detail

MEDICARE: SANTA ROSA COMMUNITY HEALTH CENTERS

MEDICARE: SANTA ROSA COMMUNITY HEALTH CENTERS
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
1261Q00000XClinic/Center550000087CA
2261QF0400XFederally Qualified Health Center (FQHC)550000087CA

Other Identifiers

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

General Provider Information

NPI Number : 1578631172
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANTA ROSA COMMUNITY HEALTH CENTERS
Provider Business Mailing Address
First Line : 3569 ROUND BARN CIRCLE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-5781
Country : US
Telephone Number : 707-303-3600
Fax Number : 707-303-3635
Provider Business Practice Location Address
First Line : 3569 ROUND BARN CIRCLE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-5781
Country : US
Telephone Number : 707-303-3600
Fax Number : 707-303-3635
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : GABRIELA BERNAL-LEROI
Credential : CEO
Telephone Number : 707-303-3600
Provider Enumeration Date : 12/01/2006
Last Update Date : 12/09/2022

Similar Medicare Providers

1841979952 — KHUZEMAN ABBASI MD
Practice Location Address:
3569 ROUND BARN CIR
SANTA ROSA, CA
95403-5781
Practice Phone: 707-303-3600
Practice Fax:
1346219755 — DR. ANTHONY F SORIA OD
Practice Location Address:
3569 ROUND BARN CIR
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95403-5781
Practice Phone: 707-303-3600
Practice Fax:
1104885672 — DR. DAVID M SCHNEIDER MD
Practice Location Address:
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SANTA ROSA, CA
95403-5781
Practice Phone: 707-303-3600
Practice Fax: 707-303-3611
1790876720 — ERIN E LUND MD
Practice Location Address:
3569 ROUND BARN CIR
SANTA ROSA, CA
95403-5781
Practice Phone: 707-303-3600
Practice Fax: 707-303-3611
1063584894 — PATRICIA G PADILLA-NOAH MD
Practice Location Address:
3569 ROUND BARN CIR
SANTA ROSA, CA
95403-5781
Practice Phone: 707-303-3600
Practice Fax: 707-303-3635
1861540486 — DANIEL ROBERT TOUB MD
Practice Location Address:
3569 ROUND BARN CIR
SANTA ROSA, CA
95403-5781
Practice Phone: 707-303-3600
Practice Fax: 707-303-3611

Directions to “SANTA ROSA COMMUNITY HEALTH CENTERS ” Practice Location

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