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General NPI Number Information
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NPI Number | 1356564173
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3448 VILLA LN SUITE 102
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-251-2000
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Fax | 707-257-7721
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Provider Business Mailing Address
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Address Line | PO BOX 31001-3059
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City | PASADENA
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State | CA
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Zip | 91110-3059
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Country | US
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Telephone | 707-251-2000
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Fax | 707-257-7721
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Authorized Official
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Title or Position | ASSISTANT SECRETARY OF ENROLLMENTS
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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