MEDICARE: AMPLA HEALTH

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	171M00000X	Case Manager/Care Coordinator
2	261QF0400X	Federally Qualified Health Center (FQHC)	230000028	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HAP03873F	OTHER	CA	FAMILY PLANNING
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	BCP03873F	OTHER	CA	EWC:CDP:BCEDP

General Provider Information

NPI Number	:	1952333635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMPLA HEALTH

Provider Business Mailing Address
First Line	:	PO BOX AD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95992-1396
Country	:	US
Telephone Number	:	530-751-3778
Fax Number	:	530-751-1237

Provider Business Practice Location Address
First Line	:	2800 LINCOLN BLVD
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-5961
Country	:	US
Telephone Number	:	530-534-7500
Fax Number	:	530-534-0210

Authorized Official
Title or Position	:	PRESIDENT, CHIEF EXECUTIVE OFFICER
Name	:	MR. BENJAMIN H FLORES
Credential	:	MPH
Telephone Number	:	530-751-3778

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	02/29/2024

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Directions to “AMPLA HEALTH ” Practice Location

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