Redwood Coast Pace

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

REDWOOD COAST PACE

Practice address

1901 California St
Eureka, CA 95501-2809

Phone

(707) 443-9747

Fax

(707) 443-3498

NPI assigned

Oct 4, 2013

Last updated

Oct 4, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

HUMBOLDT SENIOR RESOURCE CENTERAs reported in NPPES

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

Authorized official

Name

Ms. Joyce A Hayes, RDMS

Title

Executive Director

Phone

(707) 443-9747

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

IV Chemotherapeuties3 organizations share this tax ID, including this one

Part of

IV Chemotherapeuties

Other organizations with this tax ID 2

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

• Pulmonary Medicine Associates Medical Group, Inc

  • Acute Care Nurse Practitioner
  • Roseville, CA
  • NPI 1104178615
  NPD tax ID
• Pulmonary Medicine Associates Sleep Lab Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Sacramento, CA
  • NPI 1255359378
  NPD tax ID

Locations

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.

• Edgar O. Angelone, PH.D

  • Clinical Neuropsychologist
  • San Rafael, CA
  • NPI 1407919988
  NPD (past)

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1649607664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 CALIFORNIA ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012870",
            "telephone_number": "707-443-9747",
            "fax_number": "707-443-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CALIFORNIA ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955012809",
            "telephone_number": "707-443-9747",
            "fax_number": "707-443-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD COAST PACE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMBOLDT SENIOR RESOURCE CENTER",
        "enumeration_date": "2013-10-04",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-443-9747",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164644746",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MSS00009F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Reckinger, RN
• Andrew J Redden
• Laura T. Reddick, MFT
• Redwood Anesthesia Services, a Medical Corporation
• Redwood Coast Acupuncture Center Inc
• Redwood Community Action Agency (Youth Services Bureau)
• Redwood Community Action Agency (Family Services Program - Community Services Division)
• Redwood Community Services, Inc
• Redwood Community Services, Inc.
• Redwood Community Services, Inc.

• PACE Provider Organization in Eureka, CA
• Providers in Eureka, CA by specialty
• PACE Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.