Vanguard Performance, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

VANGUARD PERFORMANCE, LLC

Practice address

2901 Cleveland Ave Ste 202
Santa Rosa, CA 95403-2788

Phone

(707) 968-1555

Fax

(844) 426-0134

NPI assigned

Sep 19, 2024

Organization subpart

No

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

Authorized official

Name

Ben Pahlavan

Title

Owner

Phone

(707) 338-5927

Specialties & licenses 1

Addresses

Other names 1

• Vanguard Performance Doing business as

Locations

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1063249282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CLEVELAND AVE STE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032788",
            "telephone_number": "707-338-5927",
            "fax_number": "844-426-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CLEVELAND AVE STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032788",
            "telephone_number": "707-968-1555",
            "fax_number": "844-426-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-338-5927"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanguard Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Drew Vandell, PSY.D.
• Sonya A. Vanderheiden, MD
• Christopher Nhiawa Vang, PHARMD
• Linda Vang, OD
• Phoua Diane Vang
• Srilakshmi Vankina, MD
• Shawn Elizabeth Vanleuven
• Charlotte Vannoppen
• Jennifer Vargas Dominguez
• Yudith Vargas Dominguez

• Multi-Specialty Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.