| Dhhs Phs Ihs Phoenix Area | |
|
401 Picacho Road Winterhaven CA 92283 | |
| (760) 572-4100 | |
| (760) 572-2133 |
| Full Name | Dhhs Phs Ihs Phoenix Area |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 Picacho Road, Winterhaven, California |
| Authorized Official Name and Position | Tricia Chamberlain (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7605724100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs Phs Ihs Phoenix Area Po Box 1368 Yuma AZ 85366-2361 Ph: (760) 572-4100 | Dhhs Phs Ihs Phoenix Area 401 Picacho Road Winterhaven CA 92283 Ph: (760) 572-4100 |
| NPI Number | 1265719918 |
|---|---|
| Provider Enumeration Date | 11/09/2011 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 2668647108 |
|---|---|
| Medicare Enrollment ID | O20111212000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265719918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel J Sutton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467744557 PECOS PAC ID: 5890681043 Enrollment ID: I20040224001249 |
| Provider Name | James O Posever |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1154364214 PECOS PAC ID: 7113916198 Enrollment ID: I20040506001357 |
| Provider Name | Jason A Pollack |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831200260 PECOS PAC ID: 9032196563 Enrollment ID: I20040702000224 |
| Provider Name | Dwight R Humpherys |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740293968 PECOS PAC ID: 1153385398 Enrollment ID: I20041117000189 |
| Provider Name | Matthew J Pettengill |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1215046974 PECOS PAC ID: 1557333952 Enrollment ID: I20060321000424 |
| Provider Name | Criselle Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366517385 PECOS PAC ID: 4981656899 Enrollment ID: I20080225000741 |
| Provider Name | Rosa M Peralta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154580629 PECOS PAC ID: 3072689496 Enrollment ID: I20080909000656 |
| Provider Name | Ryan R Manning |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720058977 PECOS PAC ID: 1456404821 Enrollment ID: I20090803000115 |
| Provider Name | Cynthia A Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427295732 PECOS PAC ID: 5092860254 Enrollment ID: I20090911000457 |
| Provider Name | Antonio Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295785186 PECOS PAC ID: 9830224583 Enrollment ID: I20100319000191 |
| Provider Name | Camlesh G Nirmul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487742870 PECOS PAC ID: 0840329512 Enrollment ID: I20100519000374 |
| Provider Name | Char M Murff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114156429 PECOS PAC ID: 3476680208 Enrollment ID: I20110316000088 |
| Provider Name | Christopher K Jentoft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003040940 PECOS PAC ID: 5698929750 Enrollment ID: I20130126000003 |
| Provider Name | Marylou Karambizi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528491131 PECOS PAC ID: 4880821867 Enrollment ID: I20131219000445 |
| Provider Name | Bruce D Weaver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720149941 PECOS PAC ID: 6608099353 Enrollment ID: I20140527000912 |
| Provider Name | Bernaliza L Arce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093080590 PECOS PAC ID: 6608092077 Enrollment ID: I20140721000315 |
| Provider Name | Ashley J. Randall |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689080582 PECOS PAC ID: 2668698598 Enrollment ID: I20140729001773 |
| Provider Name | Eunis Bello |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1073839155 PECOS PAC ID: 8820218282 Enrollment ID: I20141007000423 |
| Provider Name | Kristi A Petersen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1548515406 PECOS PAC ID: 2365671583 Enrollment ID: I20150102000288 |
| Provider Name | Michael T Dubois |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720479595 PECOS PAC ID: 6507161692 Enrollment ID: I20160229000052 |
| Provider Name | Naomi H Hixson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841591096 PECOS PAC ID: 1355635210 Enrollment ID: I20160816001020 |
| Provider Name | Louise S Del Negro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366557605 PECOS PAC ID: 3971502949 Enrollment ID: I20171020001429 |
| Provider Name | Scott T Peake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497205819 PECOS PAC ID: 4880952258 Enrollment ID: I20171213002266 |
| Provider Name | Cora Lynn Tompkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295892305 PECOS PAC ID: 9638130875 Enrollment ID: I20180712001824 |
| Provider Name | Steven Grondalski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164509071 PECOS PAC ID: 2769712009 Enrollment ID: I20190930000527 |
| Provider Name | Darlene Gray-scott |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1346631447 PECOS PAC ID: 8921424631 Enrollment ID: I20200812001259 |
| Provider Name | David R Hoovestol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437183993 PECOS PAC ID: 2769515501 Enrollment ID: I20200923000204 |
| Provider Name | Brian M Shefulsky |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1992189997 PECOS PAC ID: 1052732005 Enrollment ID: I20210315000332 |
| Provider Name | Cristina Romagnoli |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578156972 PECOS PAC ID: 9436559838 Enrollment ID: I20210607000670 |
| Provider Name | Michael Santarlas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548379613 PECOS PAC ID: 8921062449 Enrollment ID: I20210709000171 |
| Provider Name | Brett J Schneiderman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831603125 PECOS PAC ID: 8325440670 Enrollment ID: I20210709001051 |
| Provider Name | Kevin V Kohler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497281521 PECOS PAC ID: 4082985767 Enrollment ID: I20210921000112 |
| Provider Name | Estrella Villarreal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780286039 PECOS PAC ID: 8820487291 Enrollment ID: I20211105002254 |
| Provider Name | Barbara Fay Willis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245395029 PECOS PAC ID: 9537153432 Enrollment ID: I20220328002410 |
| Provider Name | Sandy Nguyen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1255838041 PECOS PAC ID: 9133475817 Enrollment ID: I20220802001116 |
| Provider Name | Mercedes V Payne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225021306 PECOS PAC ID: 4385619006 Enrollment ID: I20220916003099 |
| Provider Name | Edmund Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780197293 PECOS PAC ID: 2365705241 Enrollment ID: I20230123000127 |
| Provider Name | Arthur Anthony Blain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801816525 PECOS PAC ID: 7719972322 Enrollment ID: I20230503000666 |
| Provider Name | Catherine M Lamboley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902358898 PECOS PAC ID: 4688954415 Enrollment ID: I20230929000849 |
| Provider Name | Leona M Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255389052 PECOS PAC ID: 0749204147 Enrollment ID: I20230929001157 |
| Provider Name | Shane B Benally |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588387294 PECOS PAC ID: 7810341260 Enrollment ID: I20231004000022 |
| Provider Name | Robert J Magro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811003148 PECOS PAC ID: 8820197486 Enrollment ID: I20231006002678 |
| Provider Name | Glenda S Dillingham |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1164457420 PECOS PAC ID: 4688011760 Enrollment ID: I20240325003313 |
| Provider Name | Shannon L Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497870018 PECOS PAC ID: 4183600497 Enrollment ID: I20250206003291 |
Clinicas De Salud Del Pueblo, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2133 Winterhaven Drive, Winterhaven, CA 92283 Phone: 760-572-2700 Fax: 760-572-2255 |