NPIMap

Organization Active NPI

Placer County Community Clinic

  • Public Health or Welfare Agency
  • Auburn, CA
National Provider Identifier
1205952157
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PLACER COUNTY COMMUNITY CLINIC
Practice address
11526 C Ave
Auburn, CA 95603-2704
Phone
(530) 889-7188
Fax
(530) 889-6811
NPI assigned
Mar 22, 2007
Last updated
Aug 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Authorized official

Name
Mr. Robert Long
Title
Clinic Manager
Phone
(530) 886-2910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

11526 C Ave
Auburn, CA 95603-2704

Mailing address

11583 C Ave
Auburn, CA 95603-2703
Phone (530) 889-7215

Other identifiers 1

IdentifierTypeStateIssuer
G92601-01MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Sierra Vista - North23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

11526 C Ave
Auburn, CA 95603
Phone (530) 889-7188

Practitioners & affiliated clinicians

Practitioners 1

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1205952157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11583 C AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032703",
            "telephone_number": "530-889-7215",
            "fax_number": "530-889-7280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11526 C AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032704",
            "telephone_number": "530-889-7188",
            "fax_number": "530-889-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACER COUNTY COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "530-886-2910",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92601-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; 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.