MEDICARE: WEST COUNTY HEALTH CENTERS, 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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1386524973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST COUNTY HEALTH CENTERS, INC

Provider Business Mailing Address
First Line	:	6800 PALM AVE STE A
Second Line	:
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-4226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 PALM AVE STE A
Second Line	:
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-4226
Country	:	US
Telephone Number	:	707-887-0290
Fax Number	:	707-869-1477

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	VIKKI MINNIFIELD
Credential	:
Telephone Number	:	707-271-7052

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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