NPIMap

Organization Active NPI

St. Joseph Health Northern California, LLC

Doing business as Providence Queen of the Valley Medical Center

  • Rehabilitation Hospital Unit
  • Napa, CA
National Provider Identifier
1609947282
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Doing business as
Providence Queen of the Valley Medical Center
Practice address
1000 Trancas St
Napa, CA 94558
Phone
(707) 252-4411
Fax
(707) 257-4113
NPI assigned
Nov 13, 2006
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
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

1000 Trancas St
Napa, CA 94558

Mailing address

PO Box 31001-3059
Pasadena, CA 91110-3059
Phone (707) 252-4411

Other names 1

  • Providence Queen of the Valley Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180320003140 CA Part A Provider - Hospital 8921374562 Practice locations: Napa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609947282. Details of each certification follow.

Hospital certification: CCN 05T009

Legal name
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
Doing business as
PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER
Organization structure
LLCNon-profit
Incorporated
Oct 27, 2016 in CA
Enrollment address
1000 Trancas St
Napa, CA 94558-2906
Hospital Rehabilitation Unit
Hospital subgroups
General, Acute care, Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Providence Queen of the Valley Medical CenterCCN 05T009 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 1995

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

931 Buena Vista St
Ste 202
Duarte, CA 91010
Phone (626) 301-1515

11436 Garvey Ave
El Monte, CA 91732
Phone (626) 459-5420

1860 Pennsylvania Ave
Ste 120
Fairfield, CA 94533
Phone (707) 426-4696

3300 Renner Dr
#D
Fortuna, CA 95540

315 E Route 66
Glendora, CA 91740
Phone 6269634121211

2440 S Hacienda Blvd
Ste 105
Hacienda Hts, CA 91745
Phone (626) 330-6003

1100 Trancas St
Ste 201
Napa, CA 94558
Phone (707) 251-1867

1100 Trancas St
Ste 211
Napa, CA 94558
Phone (707) 224-4250

1155 Trancas St
Napa, CA 94558
Phone (707) 252-4781

2017 Jefferson St
Napa, CA 94559
Phone (707) 224-4789

2160 Jefferson St
Ste 260
Napa, CA 94559
Phone (707) 259-0700

935 Trancas St
Ste 2C
Napa, CA 94558
Phone (707) 259-0766

18750 Colima Rd
Rowland Heights, CA 91748
Phone (626) 912-1200

4000 Civic Center Dr
San Rafael, CA 94903
Phone (415) 492-3333

1479 Ygnacio Valley Rd
Ste 200
Walnut Creek, CA 94598
Phone (925) 296-7340

1250 S Sunset Ave
#100B
West Covina, CA 91790
Phone (626) 472-0132

1250 S Sunset Ave
Ste 202
West Covina, CA 91790
Phone (626) 960-6588

Ownership & related parties

All disclosed owners & managing parties 18

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
Judith L Coffey Individual Corporate DirectorBoard Member May 26, 2021
Mary Bernadette McNulty Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
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
Shelby D Arveson Individual Corporate OfficerCfo May 30, 2024
Garry Olney Individual W-2 Managing Employee Nov 5, 2023
Conrad Hewitt Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Oct 1, 2020
Keith Flamer Individual Corporate DirectorMember, Board of Managers Nov 28, 2023
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
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 OfficerChief Executive 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, 2018 100%
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Apr 1, 2018

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 15

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

FacilityTypeRoleSince
Providence Redwood Memorial HospitalFortuna, CA, CCN 051318 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Queen of the Valley Medical CenterNapa, CA, CCN 050009 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence St. Joseph HospitalEureka, CA, CCN 050006 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2011
Providence Redwood Memorial HospitalFortuna, CA, CCN 05Z318 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Santa Rosa Memorial HospitalSanta Rosa, CA, CCN 050174 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Santa Rosa Memorial HospitalSanta Rosa, CA, CCN 05T174 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Petaluma Valley HospitalPetaluma, CA, CCN 050136 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 05Z321 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 051321 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 555590 Skilled nursing facility Operational/Managerial Control Jan 1, 2021
Providence Home Health SonomaSanta Rosa, CA, CCN 557433 Home health agency Other Apr 1, 2018
Providence Home Health HumboldtEureka, CA, CCN 057256 Home health agency Operational/Managerial Control Apr 1, 2018
Providence Hospice Napa ValleyNapa, CA, CCN 051537 Hospice Other Jun 1, 2020
Providence Hospice Sonoma CountyPetaluma, CA, CCN 051557 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Family PracticeFortuna, CA, CCN 058698 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018

Owned or controlled facilities with NPI records 21

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

View all 21

Facilities with the same owner 139

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

View all 139

Practitioners & affiliated clinicians

Practitioners 287

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 287

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1609947282",
    "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": "707-252-4411",
            "fax_number": "707-257-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TRANCAS ST",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "94558",
            "telephone_number": "707-252-4411",
            "fax_number": "707-257-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST JOSEPH HEALTH SYSTEM",
        "enumeration_date": "2006-11-13",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Queen of the Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.