NPIMap

Organization Active NPI

Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
National Provider Identifier
1962613349
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550000087 Issued in CA
Legal business name
SANTA ROSA COMMUNITY HEALTH CENTERS
Practice address
3569 Round Barn Circle
Santa Rosa, CA 95403-5781
Phone
(707) 303-3600
Fax
(707) 306-3635
NPI assigned
May 25, 2007
Last updated
Dec 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Gabriela Bernal-Leroi, CEO
Title
Chief Executive Officer
Phone
(707) 303-3600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 550000087 CA
Federally Qualified Health Center (FQHC) 261QF0400X 550000087 CA Primary

Addresses

Primary practice location

3569 Round Barn Circle
Santa Rosa, CA 95403-5781

Mailing address

3569 Round Barn Circle
Santa Rosa, CA 95403-5781
Phone (707) 303-3600

Other identifiers 2

IdentifierTypeStateIssuer
HAP71099FMedicaidCA
HAP71099FOtherCAFAMILY PACT ID

Other names 1

  • Southwest Community Health Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Santa Rosa Community Health16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1962613349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIRCLE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-303-3600",
            "fax_number": "707-303-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIRCLE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-303-3600",
            "fax_number": "707-306-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "BERNAL-LEROI",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-303-3600",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "550000087",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP71099F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT ID",
            "identifier": "HAP71099F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Community Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Southwest Community Health Center",
            "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 Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.