NPIMap

Organization Active NPI

Northern California Center for Well-Being

  • Voluntary or Charitable Agency
  • Santa Rosa, CA
National Provider Identifier
1962587964
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
NORTHERN CALIFORNIA CENTER FOR WELL-BEING
Practice address
500 Doyle Park Dr Ste 304a
Santa Rosa, CA 95405-4558
Phone
(707) 575-6043
Fax
(707) 575-1060
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Ms. Jeanette Perez
Title
Operations Manager
Phone
(707) 387-5612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

500 Doyle Park Dr Ste 304a
Santa Rosa, CA 95405-4558

Mailing address

PO Box 3644
Santa Rosa, CA 95402-3644
Phone (707) 575-6043

Other names 3

  • Center for Well-Being Doing business as
  • Northern California Center for Well-Being Doing business as
  • Center for Well - Being Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000454 CA Part B Supplier - Clinic/Group Practice 6002803608 Receives reassigned benefits from 4 practitioners
Practice locations: Santa Rosa, CA

National Provider Directory

National Provider Directory

Locations

500 Doyle Park Dr
Ste 304A
Santa Rosa, CA 95405
Phone (707) 575-6043

365 Tesconi Cir
#B
Santa Rosa, CA 95401
Phone (707) 575-6043

3536 Mendocino Ave
Ste 260
Santa Rosa, CA 95403
Phone (707) 573-6161

101 Brookwood Ave
Ste A
Santa Rosa, CA 95404
Phone (707) 575-6043

Practitioners & affiliated clinicians

Practitioners 12

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1962587964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3644",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954023644",
            "telephone_number": "707-575-6043",
            "fax_number": "707-575-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR STE 304A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-575-6043",
            "fax_number": "707-575-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA CENTER FOR WELL-BEING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "707-387-5612",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Well-Being",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern California Center for Well-Being",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Well - Being",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 25, 2023; 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.