NPIMap

Organization Active NPI

St. Joseph Health Northern California, LLC

Doing business as Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
National Provider Identifier
1609858950
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
010000075 Issued in CA
Legal business name
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Doing business as
Providence St. Joseph Hospital
Practice address
2700 Dolbeer St
Eureka, CA 95501
Phone
(707) 445-8121
Fax
(707) 269-3897
NPI assigned
Nov 14, 2005
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JOSEPH HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 010000075 CA Primary

Addresses

Primary practice location

2700 Dolbeer St
Eureka, CA 95501

Mailing address

PO Box 31001-3059
Pasadena, CA 91110-3059
Phone (707) 445-8121

Other practice location 1

2200 Harrison Ave
Eureka, CA 95501-3215
Phone (707) 441-4454

Other names 1

  • Providence St. Joseph Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marie.sorci@stjoe.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180219002015 CA Part A Provider - Hospital 8921374562 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eureka, CA
O20200706001160 CA Part B Supplier - Clinic/Group Practice 8921374562 Receives reassigned benefits from 33 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Rosa, CA; Fortuna, CA; Napa, CA; Eureka, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609858950. Details of each certification follow.

Hospital certification: CCN 050006

Legal name
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
Doing business as
PROVIDENCE ST. JOSEPH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 2, 2025
Beds
140
Ownership / control type
Private (not for profit)
Most recent change of ownership
Apr 1, 2018 (2 total)
Organization structure
LLCNon-profit
Incorporated
Oct 27, 2016 in CA
Enrollment address
2700 Dolbeer St
Eureka, CA 95501-4736
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation unit

Other NPIs on the same Medicare enrollment 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Providence St Joseph HospitalCCN 050006 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Health Northern California LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

8078 E Santa Ana Canyon Rd
Anaheim, CA 92808
Phone (714) 974-2900

2321 Harrison Ave
Ste S
Eureka, CA 95501
Phone (707) 443-2248

2612 Harrison Ave
Eureka, CA 95501
Phone (707) 269-4240

2705 Harris St
Eureka, CA 95503
Phone 70244581216802

11100 Warner Ave
Ste 320A
Fountain Valley, CA 92708
Phone (714) 545-1938

9940 Talbert Ave
Ste 201
Fountain Vly, CA 92708
Phone (714) 378-5507

12665 Garden Grove Blvd
Ste 503
Garden Grove, CA 92843
Phone (714) 530-3740

12827 Harbor Blvd
Ste G
Garden Grove, CA 92840
Phone (323) 973-2323

22 Odyssey
Ste 225
Irvine, CA 92618
Phone (949) 753-9747

500 N Garfield Ave
Ste 306
Monterey Park, CA 91754
Phone (626) 572-0660

1140 W La Veta Ave
Ste 250
Orange, CA 92868

1310 W Stewart Dr
Ste 506
Orange, CA 92868
Phone (714) 633-4957

2617 E Chapman Ave
Ste 205
Orange, CA 92869
Phone (714) 538-6822

845 W La Veta Ave
Ste 108
Orange, CA 92868
Phone (714) 289-3904

115 Hospital Dr
Ukiah, CA 95482
Phone (707) 463-1900

2001 Lind Ave SW
Renton, WA 98057

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
James C Devore Individual Corporate DirectorMember, Board of Managers Jan 1, 2018
Oluyemi Adeyanju Individual Corporate OfficerVP, Sr Corporate Counsel Apr 1, 2018
W-2 Managing Employee Jul 8, 2022
Judith L Coffey Individual Corporate DirectorBoard Member May 26, 2021
Mary Bernadette McNulty Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Timothy Herman Individual Corporate DirectorBoard Member Mar 20, 2021
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Oct 1, 2020
John Aryanpur Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
Conrad Hewitt Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Apr 1, 2018
Keith Flamer Individual Corporate DirectorBoard Member Nov 28, 2023
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
Nathan Reinert Husmann Individual Corporate OfficerCfo Apr 28, 2023
Jed Weissberg Individual Corporate DirectorBoard Member May 26, 2021
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit Other Apr 1, 2018
Laureen T Driscoll Individual Corporate OfficerExecutive Officer Jan 25, 2022
Pamela a Kindig Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
St Joseph Health Northern California LLC Organization, Irvine, CA LLC, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2011 100%
Ariel U Kelley Individual Corporate DirectorDirector Jun 16, 2022
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Apr 1, 2018

Owners & managing parties with NPI records 11

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

Practitioners & affiliated clinicians

Practitioners 282

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.

View all 282

Affiliated clinicians 504

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

View all 504

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1609858950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-3059",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911103059",
            "telephone_number": "707-445-8121",
            "fax_number": "707-269-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-445-8121",
            "fax_number": "707-269-3897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955013215",
            "country_code": "US",
            "telephone_number": "707-441-4454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOSEPH HEALTH SYSTEM",
        "enumeration_date": "2005-11-14",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "010000075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marie.sorci@stjoe.org",
            "affiliation": "N",
            "address_1": "2700 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Providence St. Joseph Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.