| Petaluma Health Center | |
|
1179 N Mcdowell Blvd Petaluma CA 94954-6559 | |
| (707) 559-7500 | |
| (707) 559-7620 |
| Full Name | Petaluma Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1179 N Mcdowell Blvd, Petaluma, California |
| Authorized Official Name and Position | Kathryn Powell (CEO) |
| Authorized Official Contact | 7075597500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petaluma Health Center 1179 N Mcdowell Blvd Petaluma CA 94954-6559 Ph: (707) 559-7597 | Petaluma Health Center 1179 N Mcdowell Blvd Petaluma CA 94954-6559 Ph: (707) 559-7500 |
| NPI Number | 1588656268 |
|---|---|
| Provider Enumeration Date | 08/18/2005 |
| Last Update Date | 03/24/2022 |
| Medicare PECOS PAC ID | 9133180375 |
|---|---|
| Medicare Enrollment ID | O20050315000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588656268 | NPI | - | NPPES |
| BCP70696F | Medicaid | CA | |
| EAP70696F | Medicaid | CA | |
| FHC70696F | Medicaid | CA | |
| 551879 | Other | CA | MEDICARE NGS |
| HAP70696F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Amy R Dilena |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790914125 PECOS PAC ID: 3173512647 Enrollment ID: I20040510000934 |
| Provider Name | Philippe R Edouard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124029491 PECOS PAC ID: 6709876212 Enrollment ID: I20040517000506 |
| Provider Name | Barbara A Williamson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306943451 PECOS PAC ID: 2961480553 Enrollment ID: I20040709001299 |
| Provider Name | Fiona C Redwood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255323945 PECOS PAC ID: 4385614064 Enrollment ID: I20040729000720 |
| Provider Name | Michelle Davey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366445785 PECOS PAC ID: 2668446618 Enrollment ID: I20040824001465 |
| Provider Name | Jonathan Y Choe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518959170 PECOS PAC ID: 6608821368 Enrollment ID: I20050315000752 |
| Provider Name | Cynthia L Weissbein Macken |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194840660 PECOS PAC ID: 9032149315 Enrollment ID: I20050817001155 |
| Provider Name | Danielle E Oryn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376535070 PECOS PAC ID: 4284659590 Enrollment ID: I20051005001205 |
| Provider Name | John Pendleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326030024 PECOS PAC ID: 6204855315 Enrollment ID: I20051117000925 |
| Provider Name | Andrew B Ashcroft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053306795 PECOS PAC ID: 0143265215 Enrollment ID: I20071113000804 |
| Provider Name | Nurit Licht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477545176 PECOS PAC ID: 6709976616 Enrollment ID: I20071215000209 |
| Provider Name | James R Palleschi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528088705 PECOS PAC ID: 3375622392 Enrollment ID: I20080501000725 |
| Provider Name | Lisa F Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083894802 PECOS PAC ID: 2769551928 Enrollment ID: I20080514000719 |
| Provider Name | Anna L Baylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538218433 PECOS PAC ID: 6103999057 Enrollment ID: I20080724000913 |
| Provider Name | Jessicca L Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891911707 PECOS PAC ID: 5294897575 Enrollment ID: I20081219000500 |
| Provider Name | Urmila A Shende |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225141245 PECOS PAC ID: 7315095635 Enrollment ID: I20090424000441 |
| Provider Name | Fasih A Hameed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417083031 PECOS PAC ID: 5991850877 Enrollment ID: I20090827000784 |
| Provider Name | Carlin L Chi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497843122 PECOS PAC ID: 0941324073 Enrollment ID: I20100826000523 |
| Provider Name | Rebecca K Finnemore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023214467 PECOS PAC ID: 8820280209 Enrollment ID: I20101004000716 |
| Provider Name | Michele D Reynolds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740486190 PECOS PAC ID: 3971798059 Enrollment ID: I20101115000998 |
| Provider Name | Mark P Sloan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063596054 PECOS PAC ID: 9830386028 Enrollment ID: I20101214000946 |
| Provider Name | Diana A Werner |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578884524 PECOS PAC ID: 5597943209 Enrollment ID: I20110628000914 |
| Provider Name | Amrita Sandhu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043542087 PECOS PAC ID: 8628249638 Enrollment ID: I20110923000396 |
| Provider Name | Donald K Bojnowski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1922385061 PECOS PAC ID: 4385810449 Enrollment ID: I20111220000894 |
| Provider Name | Samuel B Rose |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558387522 PECOS PAC ID: 9032398094 Enrollment ID: I20130403000216 |
| Provider Name | Erin J Helgerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568741494 PECOS PAC ID: 2365679008 Enrollment ID: I20131230000404 |
| Provider Name | Amy Yuh-shin Kao |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164770798 PECOS PAC ID: 2264651082 Enrollment ID: I20140910000050 |
| Provider Name | Melissa Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790184075 PECOS PAC ID: 6608180369 Enrollment ID: I20150810000208 |
| Provider Name | Kristin J Richman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1831392612 PECOS PAC ID: 2365753266 Enrollment ID: I20150921002685 |
| Provider Name | Nelson R Robles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831259746 PECOS PAC ID: 0244548055 Enrollment ID: I20150928002826 |
| Provider Name | Karl Greer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396010740 PECOS PAC ID: 8820308588 Enrollment ID: I20151109000961 |
| Provider Name | Leesa E Benenhaley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386040129 PECOS PAC ID: 8123329083 Enrollment ID: I20151217001876 |
| Provider Name | Iun In A Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114288412 PECOS PAC ID: 6709018872 Enrollment ID: I20160128002641 |
| Provider Name | Carol W Oppenheimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609101955 PECOS PAC ID: 9436454428 Enrollment ID: I20160301000529 |
| Provider Name | Patrick J Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285699553 PECOS PAC ID: 8527360460 Enrollment ID: I20160525001648 |
| Provider Name | Yolanda Psy Briscoe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508967142 PECOS PAC ID: 6800188285 Enrollment ID: I20160705001047 |
| Provider Name | Cassie J Iutzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053756346 PECOS PAC ID: 5597062067 Enrollment ID: I20160802003335 |
| Provider Name | Jillian D Geissler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780132324 PECOS PAC ID: 3072801190 Enrollment ID: I20161013000940 |
| Provider Name | Victoria Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659705564 PECOS PAC ID: 3375821697 Enrollment ID: I20161020001355 |
| Provider Name | Laura E Fannon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720104615 PECOS PAC ID: 7214215706 Enrollment ID: I20161103002574 |
| Provider Name | Whitney L Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588993927 PECOS PAC ID: 8123397841 Enrollment ID: I20170711003162 |
| Provider Name | Megan H Rehder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386013274 PECOS PAC ID: 1153622113 Enrollment ID: I20171002001484 |
| Provider Name | Karyne S Limper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881043842 PECOS PAC ID: 1850666892 Enrollment ID: I20171002001652 |
| Provider Name | Christina H Pineda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407198658 PECOS PAC ID: 1456617893 Enrollment ID: I20171117000966 |
| Provider Name | Natalie E Levine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659803369 PECOS PAC ID: 7517225782 Enrollment ID: I20171215001171 |
| Provider Name | Rosemary Healy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831521137 PECOS PAC ID: 9830459197 Enrollment ID: I20180205002786 |
| Provider Name | Randa Pycard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851809529 PECOS PAC ID: 0840552550 Enrollment ID: I20180316000935 |
| Provider Name | Megan Connick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104841576 PECOS PAC ID: 0042232779 Enrollment ID: I20180516000269 |
| Provider Name | Crysta L Pollitt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962998823 PECOS PAC ID: 3678823135 Enrollment ID: I20180918002629 |
| Provider Name | Judy S Hong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225518533 PECOS PAC ID: 0941553176 Enrollment ID: I20181128003360 |
| Provider Name | Jessica D Rhodes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427343912 PECOS PAC ID: 9133472368 Enrollment ID: I20181128003583 |
| Provider Name | Ulysses Gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427508241 PECOS PAC ID: 3173876315 Enrollment ID: I20181130000042 |
| Provider Name | Rachel M Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629551254 PECOS PAC ID: 6103160247 Enrollment ID: I20181130001345 |
| Provider Name | Judith Komatsu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346261005 PECOS PAC ID: 6709021462 Enrollment ID: I20190207000869 |
| Provider Name | Jesus Dimas-arriaga |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649723388 PECOS PAC ID: 9830437318 Enrollment ID: I20190207001327 |
| Provider Name | Anne N Sebastian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326467804 PECOS PAC ID: 0547485146 Enrollment ID: I20190221001971 |
| Provider Name | Sean R Upton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205162450 PECOS PAC ID: 1052557899 Enrollment ID: I20190311002475 |
| Provider Name | Ivonne Judith Melgar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952737322 PECOS PAC ID: 0941541122 Enrollment ID: I20190417000098 |
| Provider Name | Gisselle Elizabeth Suazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124586755 PECOS PAC ID: 3870836521 Enrollment ID: I20190520002709 |
| Provider Name | Kelly Ware |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801356605 PECOS PAC ID: 6901149699 Enrollment ID: I20190521001561 |
| Provider Name | Angie Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770049165 PECOS PAC ID: 9133462716 Enrollment ID: I20190522002789 |
| Provider Name | Jenelle Venus Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942740972 PECOS PAC ID: 3476805284 Enrollment ID: I20190605002405 |
| Provider Name | George Keres |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962707083 PECOS PAC ID: 9739548520 Enrollment ID: I20231016002349 |
| Provider Name | Scott Martinez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871370668 PECOS PAC ID: 5890143200 Enrollment ID: I20231127000155 |
| Provider Name | Samantha L Cardozo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114349578 PECOS PAC ID: 5890147615 Enrollment ID: I20240117003417 |
| Provider Name | Emma Frances Diemoz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568078921 PECOS PAC ID: 6204288988 Enrollment ID: I20240118000994 |
| Provider Name | Daniel L Wrightsman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750524674 PECOS PAC ID: 3274985569 Enrollment ID: I20240123001893 |
| Provider Name | Sonia Perez Lemus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194387878 PECOS PAC ID: 2365894664 Enrollment ID: I20240123002231 |
| Provider Name | Mariana Harms |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1710236005 PECOS PAC ID: 3870937311 Enrollment ID: I20240222004125 |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954 Phone: 707-782-9123 Fax: 707-782-9622 | |
Petaluma Eye Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1225 N Mcdowell Blvd, Petaluma, CA 94954 Phone: 707-559-7500 | |
Ranadive Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 Lynch Creek Way Ste C, Petaluma, CA 94954 Phone: 707-763-0802 Fax: 707-763-0803 | |
Nikola Lozanov, M. D., Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 108 Lynch Creek Way, Suite #4, Petaluma, CA 94954 Phone: 707-782-1244 Fax: 707-782-1163 | |
Headwaters Medical Therapy Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1355 Industrial Ave, Petaluma, CA 94952 Phone: 707-565-8188 Fax: 707-565-8190 | |
Vivacitas Medical Group Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1383 N Mcdowell Blvd Ste 110, Petaluma, CA 94954 Phone: 707-766-9852 | |
Casa Grande High School Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Casa Grande Rd, Petaluma, CA 94954 Phone: 707-559-7500 |