Mendonoma Health Alliance
Organization Active NPI Case Management Agency · Gualala, CA
NPI 1083330807 · NPPES record last updated Nov 12, 2025
Key facts
- NPI
- 1083330807
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Case Management Agency 251B00000X
- Legal business name
- MENDONOMA HEALTH ALLIANCE
- Practice address
- 39251 Ca-1
Gualala, CA 95445 - Phone
- (707) 412-3176
- Fax
- (707) 412-3196
- NPI assigned
- Oct 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Micheline Marie White
- Title
- Executive Director
- Phone
- (707) 412-3176
Practitioners 4
-
Carolyn Hand, N.P.
-
Shaye Larie, NP
-
Amelia Randolph, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2161932 | Mendonoma Health Alliance | Certificate of waiver | Feb 12, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes | ||
| Community Health Clinic/Center | 261QC1500X |
Addresses
Primary practice location
39251 Ca-1
Gualala, CA 95445
Mailing address
PO Box 1196
Gualala, CA 95445-1196
Phone (707) 412-3176
Other providers in Gualala, CA
- Shaye Larie
- Lisa Kritz Physical Therapy Inc.
- Lucinda Weaver Physical Therapy
- Jessica B Maness
- Peter W McCann
- Richard T Miner
- Elizabeth J Nagle
- Robert Arnold Nelson
- Northern California Medical Assoc Inc
- James Edwin Platt
All providers in Gualala, CA · Case Management Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.