Organization Active NPI

Vital Health Ca Medical Group

  • Family Medicine Physician
  • Penn Valley, CA
National Provider Identifier
1922728898
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VITAL HEALTH CA MEDICAL GROUP
Practice address
11386 Pleasant Valley Rd
Penn Valley, CA 95946-9000
Phone
(530) 451-6234
NPI assigned
Aug 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Brooke Jungi
Title
Practice Manager
Phone
(530) 451-6234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11386 Pleasant Valley Rd
Penn Valley, CA 95946-9000

Mailing address

11386 Pleasant Valley Rd
Penn Valley, CA 95946-9000
Phone (530) 451-6233

Other identifiers 1

IdentifierTypeStateIssuer
0OtherN/A

Other names 1

  • Vital Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Harddrive Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214002896 CA Part B Supplier - Clinic/Group Practice 2365811387 Receives reassigned benefits from 5 practitioners
Practice locations: El Dorado Hills, CA; Penn Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2289172Vital Health Ca Medical Group11386 Pleasant Valley Rd, Penn Valley, CA 95946Certificate of waiverSep 5, 2027

National Provider Directory

National Provider Directory

Locations

4944 Windplay Dr
Ste 112
El Dorado Hills, CA 95762
Phone (202) 309-9677

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1922728898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11386 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469000",
            "telephone_number": "530-451-6233",
            "fax_number": "866-531-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11386 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469000",
            "telephone_number": "530-451-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL HEALTH CA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "JUNGI",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "530-451-6234"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Harddrive",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4944 Windplay Dr Ste 112",
            "city": "El Dorado Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957629310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Vital Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vital Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Penn Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.