NPIMap

Organization Active NPI

Placer County Community Clinic

  • Public Health or Welfare Agency
  • Auburn, CA
National Provider Identifier
1487879979
Registry record updated Aug 22, 2020
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
11584 B Ave
Auburn, CA 95603-2605
Phone
(530) 889-7125
Fax
(530) 889-7280
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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 Primary

Addresses

Primary practice location

11584 B Ave
Auburn, CA 95603-2605

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
ZZR11537FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Placer County23 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

11584 B Ave
Auburn, CA 95603
Phone (530) 889-7125

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487879979",
    "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": "11584 B AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032605",
            "telephone_number": "530-889-7125",
            "fax_number": "530-889-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACER COUNTY COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR11537F",
            "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 22, 2020; 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.