SUTTER BAY MEDICAL FOUNDATION (NPI# 1528512688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528512688 |
| Entity Type | Organization |
| Organization Name | SUTTER BAY MEDICAL FOUNDATION |
| Other Organization Name | SUTTER PACIFIC MEDICAL FOUNDATION |
| Practice Address |
3883 Airway Dr Suite 120 Santa Rosa CA 95403-1670 |
| Mailing Address |
2350 W El Camino Real 3rd Floor Mountain View CA 94040-6201 |
| Practice Telephone | 7075218966 |
| Practice Fax Number | 7075231301 |
| Mailing Telephone | 6506965270 |
| Mailing Fax Number | 6506965279 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-06 |
| Authorized Official Name | JOHN B. GATES (CFO) |
| Authorized Official Telephone | 5104507357 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sutter Pacific Medical Foundation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861843955 | Sutter Bay Medical Foundation | Internal Medicine | 3880 S Bascom Ave Ste 113, San Jose, CA 95124-2600 | 2016-06-29 |
| 1679924765 | Sutter Bay Medical Foundation | Internal Medicine | 3006 S Maryland Pkwy Ste 470, Las Vegas, NV 89109-2235 | 2016-06-29 |
| 1760833834 | Sutter Bay Medical Foundation | Family Medicine | 750 Las Gallinas Ave Ste 210, San Rafael, CA 94903-3432 | 2016-06-29 |
| 1306241534 | Sutter Bay Medical Foundation | Clinic/Center | 3120 Kearney St, Fremont, CA 94538-2292 | 2014-10-30 |
| 1497996524 | Sutter Bay Medical Foundation | Clinic/Center | 3140 Kearney St, Fremont, CA 94538-2292 | 2009-03-19 |
| 1104370253 | Sutter Bay Medical Foundation | Internal Medicine | 3000 Colby St Ste 205, Berkeley, CA 94705-2058 | 2016-08-06 |
| 1841744992 | Sutter Bay Medical Foundation | Internal Medicine | 100 S San Mateo Dr, San Mateo, CA 94401-3805 | 2016-08-06 |
| 1902350168 | Sutter Bay Medical Foundation | Clinical Medical Laboratory | 3801 Sacramento St, San Francisco, CA 94118-1625 | 2016-08-05 |
| 1093269235 | Sutter Bay Medical Foundation | Clinical Medical Laboratory | 3883 Airway Dr, Suite 202, Santa Rosa, CA 95403-1670 | 2016-08-04 |
| 1992258263 | Sutter Bay Medical Foundation | Internal Medicine | 2340 Clay St, Floors 1-5 and 7, San Francisco, CA 94115-1932 | 2016-08-03 |
| Street Address |
3883 AIRWAY DR SUITE 120 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95403-1670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780646505 | Phyllis Jacqueline Senter | Family Medicine | 3883 Airway Dr, Santa Rosa, CA 95403 | 2006-04-05 |
| 1891335766 | Erin Fisher | Physician Assistant | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2020-01-08 |
| 1093269235 | Sutter Bay Medical Foundation | Clinical Medical Laboratory | 3883 Airway Dr, Suite 202, Santa Rosa, CA 95403-1670 | 2016-08-04 |
| 1053773721 | Annamaria Tedeschi | Physical Therapist | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2016-03-22 |
| 1447670526 | Sara Hoffman | Genetic Counselor, MS | 3883 Airway Dr, Rm 2-22, Santa Rosa, CA 95403-1670 | 2014-04-16 |
| 1336576347 | Dana K Kettmann | Dietitian, Registered | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2013-10-04 |
| 1881959740 | Jessica Sherwood | Dietitian, Registered | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2012-07-06 |
| 1548404494 | James Jerome Wu | Family Medicine | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2009-04-22 |
| 1124277686 | N Coast Faculty Medical Group Dba Sutter Medical Group of The Redwoods | Family Medicine | 3883 Airway Dr, Santa Rosa, CA 95403-1670 | 2008-09-09 |
| 1407021918 | Navneet Attri | Internal Medicine | 3883 Airway Dr, Suite 201, Santa Rosa, CA 95403-1670 | 2008-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549841 | Abundance Acupuncture Healing Clinic | Acupuncturist | 3410 Mendocino Avenue, Santa Rosa, CA 95403 | 2019-10-11 |
| 1982161337 | Crystal J Ward | Registered Nurse | 2350 Mendocino Ave, Ste A4, Santa Rosa, CA 95403 | 2019-02-21 |
| 1033674379 | George Edward Griese | Respiratory Therapist, Registered | 501 Bicentennial Way, Santa Rosa, CA 95403 | 2019-01-31 |
| 1508320672 | East-west Natural Medicine Inc. | Acupuncturist | 2200 Range Ave #207, Santa Rosa, CA 95403 | 2019-01-23 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1326519182 | Jkb Solutions Inc. | In Home Supportive Care | 3554 Round Barn Boulevard, Suite 311, Santa Rosa, CA 95403 | 2018-12-05 |
| 1487121265 | Catholic Charities of The Diocese of Santa Rosa | Clinic/Center | 987 Airway Ct, Santa Rosa, CA 95403 | 2018-10-30 |
| 1447746524 | Lisa Jean Quang | Optometrist | 3925 Old Redwood, Medical Office Building 4, Suite 141, Santa Rosa, CA 95403 | 2018-07-02 |
| 1598253353 | Jennifer Renee Lummus | Community Health Worker | 3614 Condo Court, Santa Rosa, CA 95403 | 2018-04-27 |
| 1871042366 | Sadie Thuet | Marriage & Family Therapist | 3434 A Mendocino Ave, Santa Rosa, CA 95403 | 2016-09-26 |
| Find all providers in zip 95403 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346889581 | Herbert Carey Pratt | Family Medicine | 4210 Thomas Lake Harris Dr Apt 217, Santa Rosa, CA 95403-5793 | 2020-01-06 |
| 1346883998 | Teresa Su | Family Medicine | 2200 County Center Dr Ste C, Santa Rosa, CA 95403-3000 | 2019-10-25 |
| 1114468568 | Erica Kumala | Family Medicine | 401 Bicentennial Way Ste 285, Santa Rosa, CA 95403-2149 | 2017-03-18 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1467745950 | Courtney King | Family Medicine | 4702 Starbuck Ave, Santa Rosa, CA 95409 | 2011-05-17 |
| 1801186648 | Adam Crawford Francis | Family Medicine | 3569 Round Barn Cir Ste 200, Santa Rosa, CA 95403-1757 | 2011-04-13 |
| 1811217003 | Dora Alicia Martinez | Family Medicine | 122 Fm 506, Santa Rosa, TX 78593-0226 | 2010-06-10 |
| 1558518290 | John Andrew Carollo Jr. | Family Medicine | 5555 Montgomery Dr Apt 36, Santa Rosa, CA 95409-5597 | 2008-08-25 |
| 1154577831 | Sutter Medical Group of The Redwoods | Family Medicine | 500 Doyle Park D., 200, Santa Rosa, CA 95405 | 2008-08-13 |
| 1013175918 | Lucia Dei Roncalli | Family Medicine | 1010 Sundown Trl, Santa Rosa, CA 95404-1115 | 2008-05-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95403 |
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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.