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NPI Code Detail

MEDICARE: SONOMA COUNTY INDIAN HEALTH PROJECT, INC

MEDICARE: SONOMA COUNTY INDIAN HEALTH PROJECT, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician110000047CA
2261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265457980
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONOMA COUNTY INDIAN HEALTH PROJECT, INC
Provider Business Mailing Address
First Line : 144 STONY POINT RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4122
Country : US
Telephone Number : 707-521-4630
Fax Number : 707-526-1016
Provider Business Practice Location Address
First Line : 144 STONY POINT RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4122
Country : US
Telephone Number : 707-521-4630
Fax Number : 707-526-1016
Authorized Official
Title or Position : CEO
Name : BETTY J ARTERBERRY
Credential :
Telephone Number : 707-521-4660
Provider Enumeration Date : 07/13/2006
Last Update Date : 02/03/2026

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Directions to “SONOMA COUNTY INDIAN HEALTH PROJECT, INC ” Practice Location

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