Active NPI
Western Sierra Medical Clinic, Inc.
Doing business as Western Sierra Medical Center
- Federally Qualified Health Center (FQHC)
- Grass Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- G43289
- Legal business name
- WESTERN SIERRA MEDICAL CLINIC, INC.
- Doing business as
- Western Sierra Medical Center
- Practice address
- 844 Old Tunnel Rd
Grass Valley, CA 95945-8524 - Phone
- (530) 273-4984
- Fax
- (530) 273-4573
- NPI assigned
- Nov 30, 2005
- Last updated
- Mar 19, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Francine Novak
- Title
- Pdo
- Phone
- (530) 802-2706
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | G43289 | CA | Primary |
Addresses
Primary practice location
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Mailing address
844 Old Tunnel Rd
Grass Valley
Grass Valley, CA 95945-8524
Phone (530) 273-4984
Other names 1
- Western Sierra Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 4
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040923000686 | CA | Part B Supplier - Clinic/Group Practice | 3971571217 |
Receives reassigned benefits from 58 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Auburn, CA; Downieville, CA; Grass Valley, CA; Kings Beach, CA; Penn Valley, CA |
| O20100826000389 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Grass Valley, CA |
| O20250317003278 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Nevada City, CA |
| O20250811002500 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Nevada City, CA |
NPI to CCN mapping 3
The Medicare certification numbers (CCNs) connected to NPI 1063496396. Details of each certification follow.
Federally qualified health center certification: CCN 051002
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Doing business as
- WESTERN SIERRA MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 16, 2005
- Last certification
- Mar 16, 2005
- Ownership / control type
- For profit – corporation
- Most recent change of ownership
- Sep 2, 2010 (1 total)
- Organization structure
- Corporation
- Incorporated
- Aug 24, 1976 in CA
- Enrollment address
- 844 Old Tunnel Road
Grass Valley, CA 95945-5952
Federally qualified health center certification: CCN 551863
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 21, 1999
- Last certification
- Jun 21, 1999
- Ownership / control type
- For profit – partnership
- Most recent change of ownership
- Mar 1, 2025 (1 total)
- Organization structure
- Corporation
- Enrollment address
- 15301 Tyler Foote Rd
Nevada City, CA 95959-9318
Federally qualified health center certification: CCN A01181
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 8, 2023
- Last certification
- Aug 8, 2023
- Ownership / control type
- For profit – corporation
- Most recent change of ownership
- Apr 1, 2025 (1 total)
- Organization structure
- Corporation
- Enrollment address
- 590 Searls Ave
Ste a
Nevada City, CA 95959-3053
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Sierra Family Health Center
- Federally Qualified Health Center (FQHC)
- Nevada City, CA
- NPI 1427827161
3971571217
-
- Federally Qualified Health Center (FQHC)
- Oregon House, CA
- NPI 1780463257
3971571217
-
- Urgent Care Clinic/Center
- Downieville, CA
- NPI 1851513469
3971571217
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Urgent Care Clinic/Center
- Downieville, CA
- NPI 1851513469
O20040923000686
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1021089 | Western Sierra Medical Clinic | Provider-performed microscopy | Aug 18, 2026 |
National Provider Directory
National Provider DirectoryLocations
1345 Whispering Pines Ln
Grass Valley, CA 95945
Phone (530) 265-7895
101 Providence Mine Rd
Ste 101
Nevada City, CA 95959
Phone (530) 265-2914
700 Zion St
Nevada City, CA 95959
Phone (530) 265-0718
700 Zion St
Ste H
Nevada City, CA 95959
Phone (530) 265-7850
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Ownership & related parties
All disclosed owners & managing parties 22
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lupe R Peterson | Corporate Director | Jun 30, 2010 | |
| Corporate Director | Dec 19, 2009 | ||
| Corporate Director | Apr 1, 2025 | ||
| Peter Scott Browne | Corporate Director | Jun 30, 2010 | |
| Corporate Director | Dec 19, 2009 | ||
| Corporate Director | Apr 1, 2025 | ||
| Florence Events | Corporate Director | Jun 30, 2010 | |
| Carolyn Larson | Corporate Director | Jun 30, 2010 | |
| Katherine a Medeiros | Corporate Director | Jun 30, 2010 | |
| Elizabeth Luster | Corporate Director | Jun 30, 2010 | |
| Richard Kuhwarth | Corporate Director | Jun 30, 2010 | |
| Regine Miller | Corporate Director | Jun 30, 2010 | |
| Brandon Pangman | Corporate Director | Jun 30, 2010 | |
| Corporate Director | Oct 20, 2004 | ||
| Corporate Director | Apr 1, 2025 | ||
| Jessica Lance | Corporate Officer | Apr 1, 2022 | |
| Noel Chapman | Corporate Officer | Nov 29, 2016 | |
| Pete Villarreal | Corporate Director | Jun 30, 2010 | |
| Jennifer Malone | Corporate Director | Apr 1, 2020 | |
| Corporate Officer | Jul 1, 2020 | ||
| Corporate Officer | Nov 1, 2024 | ||
| Anita Daniels | Corporate Director | Jun 30, 2010 | |
| Corporate Director | Jan 1, 2001 | ||
| Corporate Director | Apr 1, 2025 | ||
| Francine Novak | W-2 Managing Employee | Jun 30, 2010 | |
| W-2 Managing Employee | Nov 1, 2024 | ||
| W-2 Managing Employee | Apr 1, 2025 | ||
| Linda Greenlee | Corporate Director | Feb 27, 2019 | |
| Corporate Director | Apr 1, 2025 | ||
| Robert L Oldham | Corporate Director | Dec 28, 2016 | |
| Corporate Director | Apr 1, 2025 | ||
| Lisa Wilson | Corporate Director | Feb 23, 2022 | |
| Corporate Director | Apr 1, 2025 | ||
| Donald S Russell | Corporate Director | Dec 19, 2019 | |
| Corporate Director | Apr 1, 2025 | ||
| Robert Shapiro | Corporate Director | Dec 19, 2024 | |
| Corporate Director | Apr 1, 2025 | ||
| Paulette Taylor | Corporate Director | Dec 19, 2024 | |
| Corporate Director | Apr 1, 2025 | ||
| Derek M Williams | Corporate Director | Jul 27, 2011 | |
| Corporate Director | Apr 1, 2025 |
Change-of-ownership history 2
| Date | Event | Counterparty |
|---|---|---|
| Apr 1, 2025 | Change of Ownership | Sierra Family Medical Clinic Inc |
| Mar 1, 2025 | Change of Ownership | Sierra Family Medical Clinic Inc |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
dba Sierra Family Health Center
- Federally Qualified Health Center (FQHC)
- Nevada City, CA
- NPI 1316169618
Acquired from, 2025-03-01, Acquired from, 2025-04-01
Practitioners & affiliated clinicians
Practitioners 61
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.
-
- Family Nurse Practitioner
- Santa Rosa, CA
- NPI 1053341354
-
- Family Medicine Physician
- Fresno, CA
- NPI 1114120474
-
- Family Nurse Practitioner
- Sacramento, CA
- NPI 1851911002
-
- General Practice Dentistry
- Inglewood, CA
- NPI 1801071089
-
- Medical Physician Assistant
- Grass Valley, CA
- NPI 1033800420
-
- Physician Assistant
- Grass Valley, CA
- NPI 1841938057
-
- Marriage & Family Therapist
- Nevada City, CA
- NPI 1164542411
-
- General Practice Physician
- Stockton, CA
- NPI 1457768566
-
- Mental Health Counselor
- Grass Valley, CA
- NPI 1619200219
-
- Ambulatory Women's Health Care Registered Nurse
- Grass Valley, CA
- NPI 1013571231
-
- Obstetrics & Gynecology Physician
- Yuba City, CA
- NPI 1902826894
-
- Family Medicine Physician
- Auburn, CA
- NPI 1780795930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773878400000",
"number": "1063496396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "844 OLD TUNNEL RD",
"address_2": "GRASS VALLEY",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959458524",
"telephone_number": "530-273-4984",
"fax_number": "530-273-4573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "844 OLD TUNNEL RD",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959458524",
"telephone_number": "530-273-4984",
"fax_number": "530-273-4573"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTERN SIERRA MEDICAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-30",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A",
"authorized_official_last_name": "NOVAK",
"authorized_official_first_name": "FRANCINE",
"authorized_official_title_or_position": "PDO",
"authorized_official_telephone_number": "530-802-2706"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CA",
"license": "G43289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Western Sierra Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Western Sierra Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.