CHW Medical Foundation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CHW MEDICAL FOUNDATION

Doing business as

Woodland Clinic, a Service of CHW Medical Foundation

Practice address

239 W Court St
Woodland, CA 95695-2900

Phone

(530) 668-2656

Fax

(530) 662-4527

NPI assigned

Mar 26, 2007

Last updated

Nov 18, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

CHW MEDICAL FOUNDATIONAs reported in NPPES

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

Authorized official

Name

Theresa M Hylen

Title

Chief Financial Officer

Phone

(916) 851-2559

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Woodland Clinic, a Service of CHW Medical Foundation Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Part of

Woodland Clinic Med GRP

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.

• Jessica M Chabot, M.D.

  • Emergency Medicine Physician
  • Woodland, CA
  • NPI 1871519603
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1881711547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 COTTONWOOD ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956955131",
            "telephone_number": "530-666-1631",
            "fax_number": "530-666-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 W COURT ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952900",
            "telephone_number": "530-668-2656",
            "fax_number": "530-662-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHW MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHW MEDICAL FOUNDATION",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "HYLEN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "916-851-2559"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0091674",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ52383Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0013030",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "571205856",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Clinic, a Service of CHW Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodland Clinic, a Service of CHW Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Minzi Chen, MD
• Hong Cheng, DDS
• Craighton Chin, M.D.
• Yilin Chu, M.D.
• CHW Medical Foundation (Woodland Clinic, a Service of CHW Medical Foundation)
• CHW Medical Foundation (Woodland Clinic, a Service of CHW Medical Foundation)
• Danielle Clark
• Marijo Classen
• Christopher Keith Claus, D.D.S., M.S.D.
• Debbie Carrion Clifford

• Multi-Specialty Clinic/Center in Woodland, CA
• Providers in Woodland, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.