| Long Valley Health Center | |
| 
					50 Branscomb Road Laytonville CA 95454  | |
| (707) 984-6131 | |
| (707) 984-6990 | 
| Full Name | Long Valley Health Center | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 50 Branscomb Road, Laytonville, California | 
| Authorized Official Name and Position | Rodney O Grainger (EXECUTIVE DIRECTOR) | 
| Authorized Official Contact | 7079846131 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Long Valley Health Center Po Box 870 Laytonville CA 95454-0870 Ph: (707) 984-6131  | Long Valley Health Center 50 Branscomb Road Laytonville CA 95454 Ph: (707) 984-6131  | 
| NPI Number | 1366467375 | 
|---|---|
| Provider Enumeration Date | 07/12/2006 | 
| Last Update Date | 11/07/2013 | 
| Medicare PECOS PAC ID | 8628965852 | 
|---|---|
| Medicare Enrollment ID | O20040302001373 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1366467375 | NPI | - | NPPES | 
| FHC70034F | Medicaid | CA | |
| ZZZ84629Z | Other | NHIC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary | 
| Provider Name | Lynna R Young | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1295730984 PECOS PAC ID: 4486540333 Enrollment ID: I20040226000490  | 
| Provider Name | Peter Y Cho | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1619968948 PECOS PAC ID: 2961468830 Enrollment ID: I20050413001007  | 
| Provider Name | Carla P Longchamp | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1972544948 PECOS PAC ID: 8729003942 Enrollment ID: I20051006000906  | 
| Provider Name | Angela R Miller | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1285739128 PECOS PAC ID: 1153424759 Enrollment ID: I20070320000614  | 
| Provider Name | Andrea P Mccullough | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1366535890 PECOS PAC ID: 7012819469 Enrollment ID: I20070816000761  | 
| Provider Name | Stuart Sultze | 
|---|---|
| Provider Type | Practitioner - Chiropractic | 
| Provider Identifiers | NPI Number: 1659320729 PECOS PAC ID: 5799860383 Enrollment ID: I20080306000360  | 
| Provider Name | Sharon R Paltin | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1881627693 PECOS PAC ID: 6800964164 Enrollment ID: I20081014000427  | 
| Provider Name | Cindy J Norvell | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1093733669 PECOS PAC ID: 3375601156 Enrollment ID: I20081023000032  | 
| Provider Name | Thomas A Bertolli | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1811089717 PECOS PAC ID: 4385799568 Enrollment ID: I20090911000627  | 
| Provider Name | Laura Neimark-gizara | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1932359429 PECOS PAC ID: 5496906802 Enrollment ID: I20150923000651  | 
| Provider Name | Belinda D De Shay | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1811201924 PECOS PAC ID: 2567764848 Enrollment ID: I20160104000851  | 
| Provider Name | Larann R Henderson | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1457584062 PECOS PAC ID: 6305126343 Enrollment ID: I20161208000217  | 
| Provider Name | Kathleen A Sharpe | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1831551035 PECOS PAC ID: 4082912704 Enrollment ID: I20170619000911  | 
| Provider Name | Carrie A Guilfoyle | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1700316601 PECOS PAC ID: 3476810722 Enrollment ID: I20171122000834  | 
| Provider Name | Jodi L Parungao | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1932528965 PECOS PAC ID: 1355560954 Enrollment ID: I20181016003217  | 
| Provider Name | Anuradha Challa | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1518195825 PECOS PAC ID: 2567696644 Enrollment ID: I20210127002959  | 
| Provider Name | Tami Blecha | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1578156402 PECOS PAC ID: 0941617518 Enrollment ID: I20210830001464  | 
| Provider Name | Shaelah Ellen Lewis | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1710654660 PECOS PAC ID: 5193118164 Enrollment ID: I20220215002682  | 
| Provider Name | Roshanda Grayson-thomas | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1619415874 PECOS PAC ID: 7214342930 Enrollment ID: I20221026000199  | 
| Provider Name | Aliza Menashe | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1962894147 PECOS PAC ID: 6406223528 Enrollment ID: I20221102002566  | 
| Provider Name | Haley Megan Morse | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1174153746 PECOS PAC ID: 4284001322 Enrollment ID: I20221103000076  | 
| Provider Name | Samuel Martisius | 
|---|---|
| Provider Type | Practitioner - General Practice | 
| Provider Identifiers | NPI Number: 1043440308 PECOS PAC ID: 1052559762 Enrollment ID: I20230118001335  | 
| Provider Name | Cecelia Pooleygillespie | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1891149076 PECOS PAC ID: 0749654903 Enrollment ID: I20230330000364  | 
| Provider Name | Cayo Alba | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1164718334 PECOS PAC ID: 3072767813 Enrollment ID: I20231017002960  | 
| Provider Name | Grace Marie Sakurada | 
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist | 
| Provider Identifiers | NPI Number: 1780128793 PECOS PAC ID: 2961841325 Enrollment ID: I20240417003713  |