Healthcare Provider Details

I. General information

NPI: 1083602122
Provider Name (Legal Business Name): WILLITS HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MARCELA DRIVE
WILLITS CA
95490-5769
US

IV. Provider business mailing address

PO BOX 888828
LOS ANGELES CA
90088-8828
US

V. Phone/Fax

Practice location:
  • Phone: 707-459-6801
  • Fax: 707-459-9486
Mailing address:
  • Phone: 707-459-6801
  • Fax: 707-459-9486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number110000013
License Number StateCA

VIII. Authorized Official

Name: PARKER J PRIDGEN
Title or Position: PRESIDENT
Credential:
Phone: 707-456-3010