Individual provider Active NPI

Ricco Vasquez

  • Community Health Worker
  • Santa Rosa, CA
National Provider Identifier
1053048082
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
4415 Sonoma Hwy Ste B
Santa Rosa, CA 95409-4165
Phone
(707) 327-0909
Fax
(707) 581-1995
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

4415 Sonoma Hwy Ste B
Santa Rosa, CA 95409-4165

Mailing address

1100 Lincoln Ave Ste 108
Napa, CA 94558-4908
Phone (415) 861-0828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1053048082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LINCOLN AVE STE 108",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945584908",
            "telephone_number": "415-861-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 SONOMA HWY STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954094165",
            "telephone_number": "707-327-0909",
            "fax_number": "707-581-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "RICCO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.