Chapa-de Indian Health Program, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

030000513 Issued in CA

Legal business name

CHAPA-DE INDIAN HEALTH PROGRAM, INC.

Practice address

175 W Court St
Woodland, CA 95695-2913

Phone

(530) 887-2800

Fax

(530) 887-2807

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Sierk Haitsma

Title

Chief Financial Officer

Phone

(530) 887-2841

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WOODLAND CLINIC Other name

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1174653059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11670 ATWOOD RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039522",
            "telephone_number": "530-887-2800",
            "fax_number": "530-887-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W COURT ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952913",
            "telephone_number": "530-887-2800",
            "fax_number": "530-887-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPA-DE INDIAN HEALTH PROGRAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "HAITSMA",
        "authorized_official_first_name": "SIERK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "530-887-2841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "030000513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THP70647F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODLAND CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Trudy M Chan, R.D.
• Anjali Shayal Chandra
• Evonne Renee Chaney
• Ernest Chang, OD
• Alex Chao, DO
• Maria Sandoval Charles, RADT
• Alondra Chavez Diaz
• Roxana Chavez Ramirez
• Cecilia Esther Chavez Zamudio, CWC II
• Alycia Breanne Chavez

• Federally Qualified Health Center (FQHC) in Woodland, CA
• Providers in Woodland, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.