| 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 | 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 S 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 | Susan M Meffert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598895724 PECOS PAC ID: 0547438822 Enrollment ID: I20110713000425 |
| Provider Name | Laura Lynn 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 | Jessica B Maness |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346538030 PECOS PAC ID: 5890092365 Enrollment ID: I20160328002291 |
| 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 | Jessica K Ehlers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003249525 PECOS PAC ID: 5395071773 Enrollment ID: I20190723001771 |
| Provider Name | Anuradha Challa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518195825 PECOS PAC ID: 2567696644 Enrollment ID: I20210127002959 |
| 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 |