Active NPI
Tuolumne Mewuk Indian Health Center, Inc
- Family Medicine Physician
- Tuolumne, CA
National Provider Identifier
1619952397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G50654
- Legal business name
- TUOLUMNE MEWUK INDIAN HEALTH CENTER, INC
- Practice address
- 18880 Cherry Valley Blvd
Tuolumne, CA 95379-9612 - Phone
- (209) 928-5450
- Fax
- (209) 928-5414
- NPI assigned
- Dec 14, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Becky Shokraii
- Title
- Chief Administrative Officer
- Phone
- (209) 459-7933
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY18496 | CA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Family Medicine Physician | 207Q00000X | G73139 | CA | |
| Family Medicine Physician | 207Q00000X | 20A7824 | CA | |
| Family Medicine Physician | 207Q00000X | G32948 | CA | |
| Family Medicine Physician | 207Q00000X | G50654 | CA | Primary |
| Pediatrics Physician | 208000000X | A53764 | CA | |
| Psychiatry Physician | 2084P0800X | A62628 | CA | |
| Physician Assistant | 363A00000X | PA15883 | CA | |
| Family Nurse Practitioner | 363LF0000X | NP14383 | CA |
Addresses
Primary practice location
18880 Cherry Valley Blvd
Tuolumne, CA 95379-9612
Mailing address
18880 Cherry Valley Blvd
Tuolumne, CA 95379-9506
Phone (209) 928-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050128000861 | CA | Part B Supplier - Clinic/Group Practice | 6507816386 |
Receives reassigned benefits from 45 practitioners 1 other NPI on this enrollment Practice locations: Sonora, CA; Tuolumne, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Family Medicine Physician
- Sonora, CA
- NPI 1124286885
O20050128000861
National Provider Directory
National Provider DirectoryLocations
19969 Greenley Rd
Ste E
Sonora, CA 95370
14550 Mono Way
Sonora, CA 95370
Phone (209) 532-7192
18352 Tuolumne Rd
Ste 7
Tuolumne, CA 95379
Practitioners & affiliated clinicians
Practitioners 59
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Sunland, CA
- NPI 1306392873
CA, Family
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1763683200000",
"number": "1619952397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18880 CHERRY VALLEY BLVD",
"city": "TUOLUMNE",
"state": "CA",
"postal_code": "953799506",
"telephone_number": "209-928-5400",
"fax_number": "209-928-5414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18880 CHERRY VALLEY BLVD",
"city": "TUOLUMNE",
"state": "CA",
"postal_code": "953799612",
"telephone_number": "209-928-5450",
"fax_number": "209-928-5414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TUOLUMNE MEWUK INDIAN HEALTH CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-14",
"last_updated": "2025-11-21",
"certification_date": "2025-11-21",
"status": "A",
"authorized_official_last_name": "SHOKRAII",
"authorized_official_first_name": "BECKY",
"authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "209-459-7933"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY18496",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "G73139",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "20A7824",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "G32948",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "G50654",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "CA",
"license": "A53764",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A62628",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15883",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP14383",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuolumne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.