Healthcare Provider Details

I. General information

NPI: 1093652349
Provider Name (Legal Business Name): HEALDSBURG DIRECT CARE AN ADVANCED PRACTICE NURSING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 MARCH AVE STE B
HEALDSBURG CA
95448-3385
US

IV. Provider business mailing address

455 MARCH AVE STE B
HEALDSBURG CA
95448-3385
US

V. Phone/Fax

Practice location:
  • Phone: 707-370-7000
  • Fax:
Mailing address:
  • Phone: 707-370-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANN MARIE MCDONALD
Title or Position: OWNER
Credential: NP
Phone: 707-370-7000