NPIMap

Organization Active NPI

Consolidated Tribal Health Project, Inc.

  • Health Service Clinic/Center
  • Redwood Valley, CA
National Provider Identifier
1003826009
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
110000210 Issued in CA
Legal business name
CONSOLIDATED TRIBAL HEALTH PROJECT, INC.
Practice address
6991 N State St
Redwood Valley, CA 95470-9629
Phone
(707) 485-5115
Fax
(707) 467-5698
NPI assigned
Aug 9, 2006
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Guzman, MSW
Title
Executive Director
Phone
(707) 467-5616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 110000210 CA Primary

Addresses

Primary practice location

6991 N State St
Redwood Valley, CA 95470-9629

Mailing address

PO Box 387
Calpella, CA 95418-0387
Phone (707) 485-5115

Other identifiers 3

IdentifierTypeStateIssuer
THP70442FMedicaidCA
EAP70442FOtherCAEAPC
HAP70442FOtherCAFAMILY PACT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050714000893 CA Part B Supplier - Clinic/Group Practice 1456260736 Receives reassigned benefits from 37 practitioners
Practice locations: Redwood Valley, CA
O20140904000227 CA Part A Provider - Indian Health Services Facility 1456260736 Practice locations: Redwood Valley, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1003826009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "CALPELLA",
            "state": "CA",
            "postal_code": "954180387",
            "telephone_number": "707-485-5115",
            "fax_number": "707-485-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6991 N STATE ST",
            "city": "REDWOOD VALLEY",
            "state": "CA",
            "postal_code": "954709629",
            "telephone_number": "707-485-5115",
            "fax_number": "707-467-5698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSOLIDATED TRIBAL HEALTH PROJECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "GUZMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-467-5616",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "110000210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THP70442F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP70442F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT",
            "identifier": "HAP70442F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.