NPIMap

Organization Active NPI

Sonoma Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sonoma, CA
National Provider Identifier
1093854036
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
110000251 Issued in CA
Legal business name
SONOMA VALLEY COMMUNITY HEALTH CENTER
Practice address
19270 Sonoma Highway 12
Sonoma, CA 95476-5414
Phone
(707) 939-6070
Fax
(707) 939-6077
NPI assigned
Feb 6, 2007
Organization subpart
Yes
Parent organization
SONOMA VALLEY COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Authorized official

Name
Charyl K Johnson
Title
Ceo
Phone
(707) 939-6075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 110000251 CA Primary

Addresses

Primary practice location

19270 Sonoma Highway 12
Sonoma, CA 95476-5414

Mailing address

19270 Sonoma Highway 12
Sonoma, CA 95476-5414
Phone (707) 939-6070

Other identifiers 3

IdentifierTypeStateIssuer
FHC53855FMedicaidCA
HAP53855FMedicaidCA
BCP53855FMedicaidCA

Other names 1

  • Sonoma Valley Community Health Center Mobile Van Doing business as

National Provider Directory

National Provider Directory
Part of
Sonoma Valley Community

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1093854036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19270 SONOMA HIGHWAY 12",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765414",
            "telephone_number": "707-939-6070",
            "fax_number": "707-939-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19270 SONOMA HIGHWAY 12",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765414",
            "telephone_number": "707-939-6070",
            "fax_number": "707-939-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA VALLEY COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SONOMA VALLEY COMMUNITY HEALTH CENTER",
        "enumeration_date": "2007-02-06",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHARYL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-939-6075"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "110000251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC53855F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP53855F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP53855F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sonoma Valley Community Health Center Mobile Van",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonoma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.