Sutter Valley Medical Foundation

Organization Active NPI Rural Health Clinic/Center · Brownsville, CA

NPI 1740422286 · NPPES record last updated Mar 18, 2026

Key facts

NPI
1740422286
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
230000331 (CA)
Legal business name
SUTTER VALLEY MEDICAL FOUNDATION
Practice address
16911 Willow Glen Road
Brownsville, CA 95919
Phone
(530) 675-2457
Fax
(530) 675-0530
NPI assigned
Mar 30, 2009
Organization subpart
Yes
Parent organization (as reported)
SUTTER MEDICAL FOUNDATION

Authorized official

Name
Kristin Keller
Title
Sr. Director, Planning and Alignmen
Phone
(650) 934-7000

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Owners & managing parties with NPI records 4

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

Other NPIs with the same Medicare PAC ID 23

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

Corporate family (same tax ID) 35

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

View all 35

Practitioners 2,473

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 2,473

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Rural health clinic certification: CCN 553950

Legal name
SUTTER VALLEY MEDICAL FOUNDATION
Doing business as
SUTTER NORTH BROWNSVILLE FAMILY PRACTICE CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2002
Last certification
Feb 23, 2017
Ownership / control type
2B
Most recent change of ownership
Nov 1, 2009 (2 total)
Organization structure
Corporation · Non-profit
Incorporated
Apr 8, 1992 in CA
Enrollment address
16911 Willow Glen Rd
Brownsville, CA 95919-9707

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peter V Hull
Individual
Corporate Director
Board Member
Jan 1, 2012
Stacey May Saefong Tan
Individual
W-2 Managing Employee Jan 1, 2023
Suheir Haddad
Individual
Corporate Officer
Cfo
Apr 1, 2023
I-Mei Hsiu
Individual
Corporate Director
Board Member
May 21, 2015
Todd C Smith
Individual
Corporate Director
Board Member
May 21, 2015
Helen M Thomson
Individual
Corporate Director
Board Member
Feb 7, 2011
David H Adkins
Individual
Corporate Director
Board Member
May 21, 2015
Krista Lopes
Individual
Corporate Officer
VP, Quality, Safety & Patient Exp
Apr 1, 2024
Timothy a Byrd
Individual
Corporate Director
Board Member
May 21, 2015
Connie Baker
Individual
W-2 Managing Employee
Regional Manager
Jan 4, 2010
Kurt J Shuler
Individual
Corporate Director
Board Member
Jan 1, 2015
Stephanie Moser
Individual
W-2 Managing Employee Nov 23, 2023
Warner L. Thomas
Individual
Corporate Director
President/Ceo
Dec 28, 2022
Sutter Health
Organization
Corporation, Non-profit
Other May 1, 1992 100%
Viva Ettin
Individual
Corporate Director
Board Member
Feb 7, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20091030000248 CA Part a Provider - Rural Health Clinic 9830094515 Practice locations: Brownsville, CA

National Provider Directory

Tax ID family
Sutter Medical Foundation North Bay (36 organizations share this tax ID)
Part of
Sutter Medical Foundation North Bay

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 230000331 CA Yes
Clinical Medical Laboratory 291U00000X 05D0617902 CA

Addresses

Primary practice location

16911 Willow Glen Road
Brownsville, CA 95919

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (916) 854-6975

Other identifiers

IdentifierTypeStateIssuer
RHM53950GMedicaidCA

Other names

  • Sutter North Brownsville Family Practice Center Doing business as

Other providers in Brownsville, CA

All providers in Brownsville, CA · Rural Health Clinic/Center in California

Sources for this page

Verify at the official NPI Registry.