City of Petaluma Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF PETALUMA AMBULANCE SERVICE

Practice address

198 D St
Petaluma, CA 94952-3028

Phone

(707) 778-4364

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Chris Albertson

Title

Fire Chief

Phone

(707) 778-4364

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1720087661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ENGLISH ST STE 1",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 D ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523028",
            "telephone_number": "707-778-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PETALUMA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "ALBERTSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "707-778-4364"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ31259Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "756590183",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Christianson
• Nataliya Chul
• Elene Hwa-Yihg Chung, L.AC.
• Michelle Rose Ciaravella, L.P.N.
• Cinnabar School District
• Civileyes LLC
• Ashley Michelle Clark
• Jennifer A Clark, LCSW
• Julie D Clark, MD
• Margaret Liberty Clark

• Land Ambulance in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.

Verify at the official NPI Registry.