WELLSPACE HEALTH (NPI# 1376188417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376188417 |
| Entity Type | Organization |
| Organization Name | WELLSPACE HEALTH |
| Practice Address |
151 N Sunrise Ave Ste 1309 Roseville CA 95661-2933 |
| Mailing Address |
777 12th St Ste 250 Sacramento CA 95814-1929 |
| Practice Telephone | 9167375555 |
| Mailing Telephone | 9165505481 |
| Mailing Fax Number | 9165203921 |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | DR. ALASDAIR JONATHAN PORTEUS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9163138413 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| WellSpace Health Sierra Gardens 2 Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720546724 | Wellspace Health | Clinic/Center | 4241 Florin Rd Ste 30, Sacramento, CA 95823-2535 | 2019-03-08 |
| 1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
| 1265777692 | Wellspace Health | Clinic/Center | 631 H St, Sacramento, CA 95814 | 2012-12-12 |
| 1679819007 | Wellspace Health | Clinic/Center | 3415 Martin Luther King Jr. Blvd, Sacramento, CA 95817-3648 | 2012-12-12 |
| 1821357492 | Wellspace Health | Clinic/Center | 8231 E Stockton Blvd, Suite C, Sacramento, CA 95828-8202 | 2012-05-16 |
| 1225335581 | Wellspace Health | Clinic/Center | 5321 Stockton Blvd, Sacramento, CA 95820-5411 | 2011-02-23 |
| 1871617688 | Wellspace Health | Community/Behavioral Health | 1550 Juliesse Ave, Sacramento, CA 95817-3648 | 2007-03-19 |
| 1275687659 | Wellspace Health | Counselor | 8233 East Stockton Blvd., Suite D, Sacramento, CA 95817-3648 | 2007-01-22 |
| 1033295084 | Wellspace Health | Community/Behavioral Health | 4441 Auburn Blvd, Suite E, Sacramento, CA 95841-4139 | 2006-10-31 |
| 1558446179 | Wellspace Health | Community/Behavioral Health | 4343 Williamsbourgh Drive, Sacramento, CA 95823-2006 | 2006-10-25 |
| Street Address |
151 N SUNRISE AVE STE 1309 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235352220 | Rhonette Estelle Jackson | Pediatrics | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2007-04-10 |
| 1063063600 | Wellspace Health | Clinic/Center | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2019-09-25 |
| 1619223534 | Kathy Lewis | Pediatrics | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2012-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063063600 | Wellspace Health | Clinic/Center | 151 N Sunrise Ave Ste 1309, Roseville, CA 95661-2933 | 2019-09-25 |
| 1538660865 | Wellspace Health | Clinic/Center | 1101 Smith Ln, Roseville, CA 95661-4103 | 2018-02-22 |
| 1811262348 | Wellspace Health | Clinic/Center | 5 Medical Plaza Dr, Suite 170, Roseville, CA 95661-2865 | 2012-03-16 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.