| Tuolumne Mewuk Indian Health Center, Inc | |
|
18880 Cherry Valley Blvd Tuolumne CA 95379-9612 | |
| (209) 928-5450 | |
| (209) 928-5414 |
| Full Name | Tuolumne Mewuk Indian Health Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 18880 Cherry Valley Blvd, Tuolumne, California |
| Authorized Official Name and Position | Janet Pepper (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 2099285453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tuolumne Mewuk Indian Health Center, Inc 18880 Cherry Valley Blvd Tuolumne CA 95379-9612 Ph: (209) 928-5450 | Tuolumne Mewuk Indian Health Center, Inc 18880 Cherry Valley Blvd Tuolumne CA 95379-9612 Ph: (209) 928-5450 |
| NPI Number | 1619952397 |
|---|---|
| Provider Enumeration Date | 12/14/2005 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Medicare PECOS PAC ID | 6507816386 |
|---|---|
| Medicare Enrollment ID | O20050128000861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619952397 | NPI | - | NPPES |
| Provider Name | Zachary A Cooper |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1659309904 PECOS PAC ID: 9537065552 Enrollment ID: I20031210000774 |
| Provider Name | Julia A Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174509103 PECOS PAC ID: 1254388804 Enrollment ID: I20050405001299 |
| Provider Name | Louella M Regis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184828964 PECOS PAC ID: 2860570959 Enrollment ID: I20080415000155 |
| Provider Name | Kerrie Robison |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407032501 PECOS PAC ID: 7517037302 Enrollment ID: I20080605000494 |
| Provider Name | Kenneth K Renwick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659344356 PECOS PAC ID: 3476612078 Enrollment ID: I20081112000209 |
| Provider Name | Trever East |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982842092 PECOS PAC ID: 2961559042 Enrollment ID: I20090407000012 |
| Provider Name | Shana R Doolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811138712 PECOS PAC ID: 8820142409 Enrollment ID: I20090817000258 |
| Provider Name | Shayna Murdock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033254586 PECOS PAC ID: 1456499847 Enrollment ID: I20110418000086 |
| Provider Name | Eleanor F Lo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508944224 PECOS PAC ID: 3476738360 Enrollment ID: I20110419000319 |
| Provider Name | John Brunolli |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801810049 PECOS PAC ID: 0042413460 Enrollment ID: I20111119000035 |
| Provider Name | Jennifer L Gerdau |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699048017 PECOS PAC ID: 5395908024 Enrollment ID: I20120516000632 |
| Provider Name | Deborah L Goreham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083014559 PECOS PAC ID: 8527383868 Enrollment ID: I20150209002172 |
| Provider Name | Nathaniel Methot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225422140 PECOS PAC ID: 6103121983 Enrollment ID: I20160217000772 |
| Provider Name | Jane L Gunter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841640687 PECOS PAC ID: 9436445731 Enrollment ID: I20160913002357 |
| Provider Name | Rebecca A Vierra-brick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477077543 PECOS PAC ID: 6709151178 Enrollment ID: I20171011001251 |
| Provider Name | Megan Mary Greenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740623420 PECOS PAC ID: 6800167990 Enrollment ID: I20171130000816 |
| Provider Name | Melanie J Osterholm-shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285967844 PECOS PAC ID: 7416216171 Enrollment ID: I20180125002972 |
| Provider Name | Erica M Vega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316367469 PECOS PAC ID: 1153672126 Enrollment ID: I20181002000757 |
| Provider Name | Jerald Martin Westendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265903918 PECOS PAC ID: 3870835804 Enrollment ID: I20190423002407 |
| Provider Name | Melanie M Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295215630 PECOS PAC ID: 0244563211 Enrollment ID: I20190605002850 |
| Provider Name | Lauren Ashlee Saunders Trask |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336573484 PECOS PAC ID: 3274968557 Enrollment ID: I20200114002515 |
| Provider Name | Scott D Gwilliam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942892815 PECOS PAC ID: 3274935135 Enrollment ID: I20210714002748 |
| Provider Name | Carol Jean Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447746011 PECOS PAC ID: 5193075562 Enrollment ID: I20221021000826 |
| Provider Name | Natalie Durnall |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437845112 PECOS PAC ID: 8022475649 Enrollment ID: I20230613000715 |