Healthcare Provider Details

I. General information

NPI: 1952217135
Provider Name (Legal Business Name): SUTTER BAY HOSPITALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18990 COYOTE VALLEY RD
HIDDEN VALLEY LAKE CA
95467-8337
US

IV. Provider business mailing address

18990 COYOTE VALLEY RD
HIDDEN VALLEY LAKE CA
95467-8337
US

V. Phone/Fax

Practice location:
  • Phone: 707-819-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN MA
Title or Position: CFO
Credential:
Phone: 650-906-0019