NPIMap

Organization Active NPI

Adventist Health Physicians Network

Doing business as St Helena Medical Specialties Hidden Valley Lake

  • Multi-Specialty Clinic/Center
  • Hidden Valley Lake, CA
National Provider Identifier
1124325220
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ADVENTIST HEALTH PHYSICIANS NETWORK
Doing business as
St Helena Medical Specialties Hidden Valley Lake
Practice address
18990 Coyote Valley Rd
Suite 8
Hidden Valley Lake, CA 95467-8337
Phone
(707) 963-5006
Fax
(707) 963-5083
NPI assigned
Feb 25, 2011
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVENTIST HEALTH PHYSICIANS NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Mr. Adrian Serna
Title
President
Phone
(916) 406-0087

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Hematology & Oncology Physician 207RH0003X NU
Obstetrics & Gynecology Physician 207V00000X NU
Urology Physician 208800000X NU

Addresses

Primary practice location

18990 Coyote Valley Rd
Suite 8
Hidden Valley Lake, CA 95467-8337

Mailing address

PO Box 888764
Los Angeles, CA 90088-8794

Other names 1

  • St Helena Medical Specialties Hidden Valley Lake Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050407000633 CA Part B Supplier - Clinic/Group Practice 3274580972 Receives reassigned benefits from 808 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
California Nedical Foun166 organizations share this tax ID, including this one
Part of
California Nedical Foun

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1124325220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888764",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888794",
            "fax_number": "707-963-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD",
            "address_2": "SUITE 8",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678337",
            "telephone_number": "707-963-5006",
            "fax_number": "707-963-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
        "enumeration_date": "2011-02-25",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "SERNA",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-406-0087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Helena Medical Specialties Hidden Valley Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Helena Medical Specialties Hidden Valley Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hidden Valley Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.