St. Joseph Home Care Network

Organization Active NPI Community Based Hospice Care Agency · Petaluma, CA

NPI 1174065809 · NPPES record last updated May 16, 2025

Key facts

NPI
1174065809
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
Legal business name
ST. JOSEPH HOME CARE NETWORK
Practice address
416 Payran St
Petaluma, CA 94952-5907
Phone
(707) 778-6242
Fax
(707) 778-0144
NPI assigned
Nov 11, 2016
Organization subpart
No

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary for Enrollment
Phone
(425) 358-9786

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Facilities with the same owner 139

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 139

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
Providence at Home With Compassus Hospice Care, Sonoma County CCN 051557
Ownership
Non-Profit
Certified
Aug 10, 1989
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA

Hospice certification: CCN 051557

Legal name
ST JOSEPH HOME CARE NETWORK
Doing business as
PROVIDENCE HOSPICE SONOMA COUNTY
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 10, 1989
Last certification
Apr 12, 2017
Ownership / control type
Non-Profit - Church
Most recent change of ownership
Sep 29, 2025
Organization structure
Corporation · Non-profit
Incorporated
Apr 19, 1994 in CA
Enrollment address
416 Payran St
Petaluma, CA 94952-5907

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dwight Story Fullerton
Individual
Corporate Director
Board Member
Mar 2, 2021
Paul Edward Swafford
Individual
Corporate Director
Board Member
Mar 4, 2022
Terri P Warren
Individual
Corporate Officer
President/Ceo
Apr 13, 2023
Providence Health & Services - Washington
Organization · Renton, WA
Corporation, Non-profit
Operational/Managerial Control Jul 1, 2016
Janice Burger
Individual
Corporate Director Dec 28, 2021
Terry Rogers
Individual
Corporate Director
Board Member
Mar 2, 2021
Robert McCann
Individual
Corporate Director
Board Member
Mar 2, 2021
Kateri Murray
Individual
Contracted Managing Employee May 1, 2023
Jody Albright
Individual
Corporate Director
Board Member
Mar 2, 2021
Nicole Sikes
Individual
W-2 Managing Employee
Director
Aug 22, 2022
Malisa J Westlund
Individual
Corporate Officer
Treasurer/Cfo
Jan 3, 2022
James Zapp
Individual
Corporate Director
Board Member
Mar 2, 2021
Larry Schecter
Individual
Corporate Director
Board Member
Mar 2, 2021
Dianna Reely
Individual
Corporate Director
Board Member
Apr 13, 2023
Donald Wayne Anderson
Individual
Corporate Officer
Assistant Secretary for Enrollment
Jan 1, 2017
Gregory David Hoffman
Individual
Corporate Officer
Evp/Cfe
Oct 1, 2020
St. Joseph Health System
Organization · Irvine, CA
Corporation, Non-profit
Other Mar 8, 2017
Rachel Arrington
Individual
Corporate Officer
Corporate Secretary
Apr 13, 2023
Shayna Stiles
Individual
W-2 Managing Employee
Administrator
Nov 1, 2022
St Joseph Health Northern California LLC
Organization · Irvine, CA
LLC, Non-profit
5% Or Greater Direct Ownership Interest Apr 1, 2018 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence Hospice Napa Valley
Napa, CA · CCN 051537
Hospice Other Jun 1, 2020

Change-of-ownership history

DateEventCounterparty
Oct 1, 2017 Change of Ownership
This provider was the buyer
Hospice of Petaluma
CCN 051557 · CA · NPI 1790770188

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20171004002045 CA Part a Provider - Hospice 2860477403 Practice locations: Santa Rosa, CA; Petaluma, CA
O20210203002973 CA Part B Supplier - Clinic/Group Practice 2860477403 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Rosa, CA

National Provider Directory

Tax ID family
St Joseph Home Care Network (5 organizations share this tax ID)

Locations

1131 Main St
Fortuna, CA 95540
Phone (707) 725-3389

205 East St
Healdsburg, CA 95448
Phone (707) 431-1135

2700 Napa Valley Corporate Dr
Ste C
Napa, CA 94558
Phone (707) 257-4124

170 Professional Center Dr
Ste B
Rohnert Park, CA 94928
Phone (707) 206-9124

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X CA Yes

Addresses

Primary practice location

416 Payran St
Petaluma, CA 94952-5907

Mailing address

PO Box 31001-1986
Pasadena, CA 91110-1986

Other names

  • Providence Hospice Sonoma County Doing business as

Other providers in Petaluma, CA

All providers in Petaluma, CA · Community Based Hospice Care Agency in California

Sources for this page

Verify at the official NPI Registry.