NPIMap

Organization Active NPI

St. Joseph Health Northern California, LLC

Doing business as Providence Queen of the Valley Medical Center

  • General Acute Care Hospital
  • Napa, CA
National Provider Identifier
1013080084
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
110000060 Issued in CA
Legal business name
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Doing business as
Providence Queen of the Valley Medical Center
Practice address
1000 Trancas St
Napa, CA 94558
Phone
(707) 252-4411
Fax
(707) 257-4113
NPI assigned
Nov 16, 2006
Last updated
May 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ST JOSEPH HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 110000060 CA Primary

Addresses

Primary practice location

1000 Trancas St
Napa, CA 94558

Mailing address

1000 Trancas St
Napa, CA 94558-2906
Phone (707) 252-4411

Other identifiers 1

IdentifierTypeStateIssuer
HSP40009FMedicaidCA

Other names 1

  • Providence Queen of the Valley Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180215000687 CA Part A Provider - Hospital 8921374562 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Napa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013080084. Details of each certification follow.

Hospital certification: CCN 050009

Legal name
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
Doing business as
PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 23, 2023
Beds
171 (147 certified)
Ownership / control type
Private (not for profit)
Most recent change of ownership
Apr 1, 2018 (2 total)
Organization structure
LLCNon-profit
Incorporated
Oct 27, 2016 in CA
Enrollment address
1000 Trancas St
Napa, CA 94558-2906
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Providence Queen of the Valley Medical CenterCCN 050009 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Health Northern California LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James C Devore Individual Corporate DirectorMember, Board of Managers Jan 1, 2018
Oluyemi Adeyanju Individual Corporate OfficerVP, Sr Corporate Counsel Apr 1, 2018
Judith L Coffey Individual Corporate DirectorMember, Board of Managers May 26, 2021
Mary Bernadette McNulty Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Oct 1, 2020
John Aryanpur Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
Shelby D Arveson Individual Corporate OfficerChief Executive May 30, 2024
Garry Olney Individual W-2 Managing EmployeeChief Executive Nov 5, 2023
Conrad Hewitt Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary for Enrollment Apr 1, 2018
Keith Flamer Individual Corporate Director Nov 28, 2023
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
Jed Weissberg Individual Corporate DirectorBoard Member May 26, 2021
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit, Chain home office Other Apr 1, 2018
Laureen T Driscoll Individual Corporate OfficerExecutive Officer Jan 25, 2022
Pamela a Kindig Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
St Joseph Health Northern California LLC Organization, Irvine, CA LLC, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2018 100%
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Apr 1, 2018

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 355

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 355

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1013080084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TRANCAS ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945582906",
            "telephone_number": "707-252-4411",
            "fax_number": "707-257-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TRANCAS ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "94558",
            "telephone_number": "707-252-4411",
            "fax_number": "707-257-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST JOSEPH HEALTH SYSTEM",
        "enumeration_date": "2006-11-16",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "110000060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40009F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Queen of the Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.