WELLSPACE HEALTH (NPI# 1396198982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396198982 |
| Entity Type | Organization |
| Organization Name | WELLSPACE HEALTH |
| Practice Address |
2425 Alhambra Blvd Sacramento CA 95817-1110 |
| Mailing Address |
1820 J St Sacramento CA 95811-3010 |
| Practice Telephone | 9167375555 |
| Practice Fax Number | 9164445620 |
| Mailing Telephone | 9167375555 |
| Mailing Fax Number | 9164445620 |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2017-08-18 |
| Authorized Official Name | 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 |
| 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 |
2425 ALHAMBRA BLVD |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-1110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203609 | Donella Jenkins | Family Medicine | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2005-05-24 |
| 1457966178 | Michelle C Woo | Nurse Practitioner | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2020-09-10 |
| 1942822663 | Kirsten Marie Dorsey | Physician Assistant | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2020-05-15 |
| 1144853060 | Wellspace Health | Pharmacy | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2020-02-19 |
| 1346724499 | Anthony Martinez | Counselor | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2018-09-24 |
| 1932617669 | Mastora Ali | Nurse Practitioner | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2018-01-16 |
| 1427573153 | Jaymee Leak Matthews | Nurse Practitioner | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2017-08-03 |
| 1023491339 | Samrawit Tekle | Family Medicine | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2015-07-06 |
| 1033507009 | Clark Lomboy | Registered Nurse | 2425 Alhambra Blvd, Sacramento, CA 95817 | 2014-12-29 |
| 1518370816 | Gian Louie Pinot | Family Medicine | 2425 Alhambra Blvd, Sacramento, CA 95817-1110 | 2014-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| 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 |
|---|---|---|---|---|
| 1265059182 | Elica Health Centers | Clinic/Center | 77 Cadillac Dr Ste 200, Sacramento, CA 95825-8337 | 2020-06-26 |
| 1508487653 | Health and Life Organization, Inc. (h.a.l.o.) | Clinic/Center | 7215 55th St Ste B, Sacramento, CA 95823-2601 | 2020-04-29 |
| 1720546724 | Wellspace Health | Clinic/Center | 4241 Florin Rd Ste 30, Sacramento, CA 95823-2535 | 2019-03-08 |
| 1073077616 | Cares Community Health | Clinic/Center | 815 S St, Sacramento, CA 95811-7064 | 2019-01-28 |
| 1982114492 | Cares Community Health | Clinic/Center | 1442 Ethan Way Ste 100, Sacramento, CA 95825-2232 | 2017-10-10 |
| 1548705874 | Elica Health Centers | Clinic/Center | 752 Revere St Unit B, Sacramento, CA 95818-2073 | 2016-12-22 |
| 1063965952 | Health for All - Revere Clinic | Clinic/Center | 752 Revere St, Unit B, Sacramento, CA 95818-2073 | 2016-07-27 |
| 1164886040 | Peach Tree Healthcare | Clinic/Center | 3810 Rosin Ct, Suite 100, Sacramento, CA 95834-1656 | 2016-04-07 |
| 1740660703 | Elica Health Centers | Clinic/Center | 1750 Wright St Ste 1, Sacramento, CA 95825-4041 | 2015-06-04 |
| 1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
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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.