| Chapa-de Indian Health Program, Inc. | |
|
11670 Atwood Rd Auburn CA 95603-9522 | |
| (530) 887-2800 | |
| (530) 887-2807 |
| Full Name | Chapa-de Indian Health Program, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 11670 Atwood Rd, Auburn, California |
| Authorized Official Name and Position | Sierk Haitsma (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5308892841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chapa-de Indian Health Program, Inc. 11670 Atwood Rd Auburn CA 95603-9522 Ph: (530) 887-2800 | Chapa-de Indian Health Program, Inc. 11670 Atwood Rd Auburn CA 95603-9522 Ph: (530) 887-2800 |
| NPI Number | 1114057163 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 01/03/2018 |
| Medicare PECOS PAC ID | 4981688520 |
|---|---|
| Medicare Enrollment ID | O20040614000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114057163 | NPI | - | NPPES |
| THP12027F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 030000189 (California) | Primary |
| Provider Name | Michael Patrick Mulligan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1053411892 PECOS PAC ID: 8820082027 Enrollment ID: I20040412000666 |
| Provider Name | Valeska E Armisen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649476243 PECOS PAC ID: 6901879543 Enrollment ID: I20040812001560 |
| Provider Name | A. David Lerner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285699595 PECOS PAC ID: 3274630249 Enrollment ID: I20070525000551 |
| Provider Name | Brett R Pinkney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033135454 PECOS PAC ID: 4385554047 Enrollment ID: I20070601000575 |
| Provider Name | Erin K Mccullough |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1114120227 PECOS PAC ID: 5597847178 Enrollment ID: I20080205000277 |
| Provider Name | Corey S Gonzales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700079316 PECOS PAC ID: 2769566884 Enrollment ID: I20080228000313 |
| Provider Name | Dean F Tomlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770695470 PECOS PAC ID: 6608944400 Enrollment ID: I20081007000354 |
| Provider Name | David D Vanzant |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710088794 PECOS PAC ID: 2769540087 Enrollment ID: I20081015000247 |
| Provider Name | Garrett M Eckerling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215937388 PECOS PAC ID: 5698836286 Enrollment ID: I20081201000379 |
| Provider Name | William Jornlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235112160 PECOS PAC ID: 3779644638 Enrollment ID: I20081210000524 |
| Provider Name | Grace Fong |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952559585 PECOS PAC ID: 7810059573 Enrollment ID: I20081215000631 |
| Provider Name | Kaya K Teh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699916007 PECOS PAC ID: 8123176450 Enrollment ID: I20090424000450 |
| Provider Name | Mihaela M Hasse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073624201 PECOS PAC ID: 5799839445 Enrollment ID: I20090815000025 |
| Provider Name | Elena Ralik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912062811 PECOS PAC ID: 4587700042 Enrollment ID: I20091014000189 |
| Provider Name | Michael Quion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326018342 PECOS PAC ID: 2365625068 Enrollment ID: I20110317000385 |
| Provider Name | Adam R Borruso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285931147 PECOS PAC ID: 2769666361 Enrollment ID: I20110406000168 |
| Provider Name | Natalia P Orozco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811288129 PECOS PAC ID: 2769653567 Enrollment ID: I20110928000376 |
| Provider Name | Patricia K Roholt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144323197 PECOS PAC ID: 3476695909 Enrollment ID: I20120424000069 |
| Provider Name | Monique A Vorous |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942567136 PECOS PAC ID: 8820242621 Enrollment ID: I20130320000030 |
| Provider Name | Raja K Sivamani |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1811197478 PECOS PAC ID: 7416196936 Enrollment ID: I20130613000382 |
| Provider Name | Scott A Dzurella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093153322 PECOS PAC ID: 9739316068 Enrollment ID: I20131212001059 |
| Provider Name | Eve A Lavalley Willsey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417269747 PECOS PAC ID: 2365679164 Enrollment ID: I20131227001046 |
| Provider Name | Meagan Mulligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093071078 PECOS PAC ID: 2163665720 Enrollment ID: I20140717000366 |
| Provider Name | Sharon E Mc Intyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104892645 PECOS PAC ID: 3173623303 Enrollment ID: I20141114000494 |
| Provider Name | Tochuku Nkadi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194952044 PECOS PAC ID: 3173678935 Enrollment ID: I20150416002366 |
| Provider Name | Marcia Johanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376564781 PECOS PAC ID: 5395797724 Enrollment ID: I20151021001896 |
| Provider Name | Kristen M Bradley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497987267 PECOS PAC ID: 3577868546 Enrollment ID: I20160229002834 |
| Provider Name | Suzarie V Spence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316339930 PECOS PAC ID: 6608169784 Enrollment ID: I20160727000920 |
| Provider Name | Alinea S Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669817540 PECOS PAC ID: 2163729500 Enrollment ID: I20161028000588 |
| Provider Name | Sara Catinari Shakked |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447540216 PECOS PAC ID: 3173767431 Enrollment ID: I20170110001928 |
| Provider Name | Karina S Gookin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184178212 PECOS PAC ID: 5890077382 Enrollment ID: I20170118000160 |
| Provider Name | Julie C Garchow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881005148 PECOS PAC ID: 9436456449 Enrollment ID: I20170920003363 |
| Provider Name | Sarah J Bland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548781495 PECOS PAC ID: 7012282676 Enrollment ID: I20171006001800 |
| Provider Name | Janet Lynn Blawn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285905182 PECOS PAC ID: 0345509600 Enrollment ID: I20180111001147 |
| Provider Name | Glenn R Gookin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285184929 PECOS PAC ID: 1759645534 Enrollment ID: I20180502001447 |
| Provider Name | Katherine Brown Capel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437481090 PECOS PAC ID: 1052660321 Enrollment ID: I20180820002005 |
| Provider Name | Dolly Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053707661 PECOS PAC ID: 4981949765 Enrollment ID: I20181226000500 |
| Provider Name | Carla E Eide |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700925724 PECOS PAC ID: 8022105493 Enrollment ID: I20190112000116 |
| Provider Name | Yarelis Soto Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033525563 PECOS PAC ID: 6103044433 Enrollment ID: I20190215001024 |
| Provider Name | Michael J Tyler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902868847 PECOS PAC ID: 9335179209 Enrollment ID: I20190416002624 |
| Provider Name | Desiree E Coniglio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366582025 PECOS PAC ID: 8426216862 Enrollment ID: I20190521001236 |
| Provider Name | Maria S Ruelas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265922710 PECOS PAC ID: 3577890938 Enrollment ID: I20190807002310 |
| Provider Name | Amy E Eargle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629247143 PECOS PAC ID: 1254663370 Enrollment ID: I20191022003884 |
| Provider Name | David Trabazo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053779777 PECOS PAC ID: 1951733518 Enrollment ID: I20191120000642 |
| Provider Name | Alexandra Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568008092 PECOS PAC ID: 8022443258 Enrollment ID: I20200128002187 |
| Provider Name | Samantha M Manzano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063035046 PECOS PAC ID: 3072937978 Enrollment ID: I20200724001961 |
| Provider Name | Marlowe G Dieckmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003304536 PECOS PAC ID: 1456604800 Enrollment ID: I20201013001531 |
| Provider Name | Shari C Fox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609994169 PECOS PAC ID: 5294152963 Enrollment ID: I20210406001941 |
| Provider Name | Joshua Olson Swigart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407347735 PECOS PAC ID: 9537410493 Enrollment ID: I20210419001811 |
| Provider Name | Kellie N Corcoran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760817258 PECOS PAC ID: 1658645353 Enrollment ID: I20210615003004 |
| Provider Name | Kathryn R Hickok |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346916152 PECOS PAC ID: 0547667461 Enrollment ID: I20210920003193 |
| Provider Name | Martin Melgoza |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366734337 PECOS PAC ID: 1658761820 Enrollment ID: I20211201002687 |
| Provider Name | Digna Cristina Cristina Cruz-grost |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699844985 PECOS PAC ID: 0345560736 Enrollment ID: I20220105002293 |
| Provider Name | Parivash Mottaghian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558554295 PECOS PAC ID: 6406237924 Enrollment ID: I20220714003924 |
| Provider Name | Kellye N Singletary |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063433324 PECOS PAC ID: 5698918480 Enrollment ID: I20220812002460 |
| Provider Name | Cheyenne R Mulder |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548801905 PECOS PAC ID: 9133503733 Enrollment ID: I20220831001706 |
| Provider Name | Kaitlyn B Spears |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053817841 PECOS PAC ID: 8325416753 Enrollment ID: I20221116001398 |
| Provider Name | Mokshasree Atluri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366947772 PECOS PAC ID: 7113395559 Enrollment ID: I20221116001620 |
| Provider Name | Sarah M Fender |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083223382 PECOS PAC ID: 4082031885 Enrollment ID: I20230615001957 |
| Provider Name | Shicara B Irvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144782095 PECOS PAC ID: 6901131192 Enrollment ID: I20231129002057 |
| Provider Name | Thomas A Seibel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083759013 PECOS PAC ID: 8426401522 Enrollment ID: I20240124004907 |
| Provider Name | Tina L Delaughter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417336835 PECOS PAC ID: 4587017454 Enrollment ID: I20240126001722 |
Western Sierra Medical Clinic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11720 Education St Ste 3, Auburn, CA 95602 Phone: 530-537-3000 Fax: 530-217-6137 | |
Covenant Health Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10831 Combie Rd Ste D, Auburn, CA 95602 Phone: 530-232-4646 | |
Thornton Chiropractic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10988 Combie Rd Ste 100, Auburn, CA 95602 Phone: 530-268-1386 | |
Uc Davis Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Bell Rd, Auburn, CA 95603 Phone: 530-888-7616 | |
Chapa-de Indian Health Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11670 Atwood Rd, Auburn, CA 95603 Phone: 530-887-2800 Fax: 530-887-2807 | |
Western Sierra Medical Clinic - Locksley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12183 Locksley Ln Ste 107, Auburn, CA 95602 Phone: 530-273-4984 Fax: 530-273-4573 |