NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Pharmacy 1 West Pharmacy 581

  • Community/Retail Pharmacy
  • Santa Rosa, CA
National Provider Identifier
1720135056
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY22113 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Pharmacy 1 West Pharmacy 581
Practice address
401 Bicentennial Way FL 1
Santa Rosa, CA 95403-2149
Phone
(707) 393-4180
Fax
(707) 393-4532
NPI assigned
Jan 5, 2007
Last updated
Feb 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Kathryn Renouard Brown
Title
VP Pharmacy Operations and Services
Phone
(510) 625-2363

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PHY22113 CA Primary

Addresses

Primary practice location

401 Bicentennial Way FL 1
Santa Rosa, CA 95403-2149

Mailing address

1800 Harrison St FL 13
Oakland, CA 94612-3466

Other identifiers 2

IdentifierTypeStateIssuer
PHA221130MedicaidCA
0572049OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • KAISER PHARMACY 1 WEST PHARMACY 581 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation Hosp Phcy379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1720135056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 13",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY FL 1",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "707-393-4180",
            "fax_number": "707-393-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "RENOUARD",
        "authorized_official_title_or_position": "VP PHARMACY OPERATIONS AND SERVICES",
        "authorized_official_telephone_number": "510-625-2363"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY22113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA221130",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0572049",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER PHARMACY 1 WEST PHARMACY 581",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER PHARMACY 1 WEST PHARMACY 581",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.