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General NPI Number Information
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NPI Number | 1801777438
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Entity Type | Organization
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Legal Business Name | PETALUMA HEALTH CENTER, INC.
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 11 4TH STREET, SUITE 1
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City | POINT REYES STATION
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State | CA
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Zip | 94956
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Country | US
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Telephone | 707-559-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1179 NORTH MCDOWELL BLVD.
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City | PETALUMA
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State | CA
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Zip | 94954
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MOLLY JOUANEH
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Credential | CMA
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Telephone | 707-559-7578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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