NPIMap

Organization Active NPI

St. Joseph Health Northern California, LLC

Doing business as Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
National Provider Identifier
1891900635
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
010000075 Issued in CA
Legal business name
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Doing business as
Providence St. Joseph Hospital
Practice address
2700 Dolbeer St
Eureka, CA 95501
Phone
(707) 445-8121
Fax
(707) 269-3897
NPI assigned
May 14, 2007
Last updated
May 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JOSEPH HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 010000075 CA Primary

Addresses

Primary practice location

2700 Dolbeer St
Eureka, CA 95501

Mailing address

PO Box 31001-3059
Pasadena, CA 91110-3059
Phone (707) 445-8121

Other practice location 1

2200 Harrison Ave
Eureka, CA 95501-3215
Phone (707) 441-4454

Other names 1

  • Providence St. Joseph Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marie.sorci@stjoe.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180219002015 CA Part A Provider - Hospital 8921374562 2 other NPIs on this enrollment
Practice locations: Eureka, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891900635. Details of each certification follow.

Hospital certification: CCN 050006

Legal name
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
Doing business as
PROVIDENCE ST. JOSEPH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 2, 2025
Beds
140
Ownership / control type
Private (not for profit)
Most recent change of ownership
Apr 1, 2018 (2 total)
Organization structure
LLCNon-profit
Incorporated
Oct 27, 2016 in CA
Enrollment address
2700 Dolbeer St
Eureka, CA 95501-4736
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation unit

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Providence St Joseph HospitalCCN 050006 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Health Northern California LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
James C Devore Individual Corporate DirectorMember, Board of Managers Jan 1, 2018
Oluyemi Adeyanju Individual Corporate OfficerVP, Sr Corporate Counsel Apr 1, 2018
W-2 Managing Employee Jul 8, 2022
Judith L Coffey Individual Corporate DirectorBoard Member May 26, 2021
Mary Bernadette McNulty Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Timothy Herman Individual Corporate DirectorBoard Member Mar 20, 2021
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Oct 1, 2020
John Aryanpur Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
Conrad Hewitt Individual Corporate DirectorMember, Board of Managers Apr 1, 2018
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Apr 1, 2018
Keith Flamer Individual Corporate DirectorBoard Member Nov 28, 2023
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
Nathan Reinert Husmann Individual Corporate OfficerCfo Apr 28, 2023
Jed Weissberg Individual Corporate DirectorBoard Member May 26, 2021
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit Other Apr 1, 2018
Laureen T Driscoll Individual Corporate OfficerExecutive Officer Jan 25, 2022
Pamela a Kindig Individual Corporate DirectorMember, Board of Managers Jan 1, 2020
St Joseph Health Northern California LLC Organization, Irvine, CA LLC, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2011 100%
Ariel U Kelley Individual Corporate DirectorDirector Jun 16, 2022
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Apr 1, 2018

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence Redwood Memorial HospitalFortuna, CA, CCN 051318 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Queen of the Valley Medical CenterNapa, CA, CCN 050009 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Redwood Memorial HospitalFortuna, CA, CCN 05Z318 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Queen of the Valley Medical CenterNapa, CA, CCN 05T009 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Santa Rosa Memorial HospitalSanta Rosa, CA, CCN 050174 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Santa Rosa Memorial HospitalSanta Rosa, CA, CCN 05T174 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Petaluma Valley HospitalPetaluma, CA, CCN 050136 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 05Z321 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 051321 Hospital Operational/Managerial Control Jan 1, 2021
Healdsburg HospitalHealdsburg, CA, CCN 555590 Skilled nursing facility Operational/Managerial Control Jan 1, 2021
Providence Home Health SonomaSanta Rosa, CA, CCN 557433 Home health agency Other Apr 1, 2018
Providence Home Health HumboldtEureka, CA, CCN 057256 Home health agency Operational/Managerial Control Apr 1, 2018
Providence Hospice Napa ValleyNapa, CA, CCN 051537 Hospice Other Jun 1, 2020
Providence Hospice Sonoma CountyPetaluma, CA, CCN 051557 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018
Providence Family PracticeFortuna, CA, CCN 058698 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2018

Owned or controlled facilities with NPI records 21

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 21

Facilities with the same owner 139

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 139

Practitioners & affiliated clinicians

Affiliated clinicians 504

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 504

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1891900635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-3059",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911103059",
            "telephone_number": "707-445-8121",
            "fax_number": "707-269-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "95501",
            "telephone_number": "707-445-8121",
            "fax_number": "707-269-3897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955013215",
            "country_code": "US",
            "telephone_number": "707-441-4454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOSEPH HEALTH SYSTEM",
        "enumeration_date": "2007-05-14",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "010000075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marie.sorci@stjoe.org",
            "affiliation": "N",
            "address_1": "2700 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Providence St. Joseph Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.