WELLSPACE HEALTH (NPI# 1548789050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548789050 |
| Entity Type | Organization |
| Organization Name | WELLSPACE HEALTH |
| Other Organization Name | WELLSPACE HEALTH ARDEN-ARCADE COMMUNITY HEALTH CENTER |
| Practice Address |
2433 Marconi Ave Sacramento CA 95821-4807 |
| Mailing Address |
777 12th St Ste 250 Sacramento CA 95814-1929 |
| Practice Telephone | 9163138455 |
| Practice Fax Number | 9163138490 |
| Mailing Telephone | 9163138455 |
| Mailing Fax Number | 9163138490 |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2019-07-30 |
| 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 |
| Other Name | Type Code |
|---|---|
| WellSpace Health Arden-Arcade 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 |
2433 MARCONI AVE |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95821-4807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578768081 | James Robert Wedell | Family Medicine | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2007-06-15 |
| 1154884484 | Laudy Rizk | Nurse Practitioner | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2019-04-12 |
| 1992278857 | Latasha Griffin | Registered Nurse | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2019-01-03 |
| 1093218869 | Ashakie Phillips | Nurse Practitioner | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2018-03-17 |
| 1780053850 | Maribel Ratuita Gabriel | Nurse Practitioner | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2015-09-18 |
| 1144663634 | Jessica Lynn Zimbardo | Nurse Practitioner | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2013-04-15 |
| 1861774192 | Lanita Rashid | Pediatrics | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2011-09-13 |
| 1457649196 | Deepti Rastogi | Pediatrics | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2011-07-15 |
| 1104026558 | I-tsyr Shaw | Internal Medicine | 2433 Marconi Ave, Sacramento, CA 95821-4807 | 2007-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100717 | Denise Renee Landgraf | Licensed Vocational Nurse | 3615 Marconi Ave, Sacramento, CA 95821 | 2020-10-05 |
| 1770053258 | Oksana A Shutkova | Behavior Technician | 2823 El Camino Avenue, Appt #19, Sacramento, CA 95821 | 2018-11-28 |
| 1871063420 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 3800 Watt Avenue Suite 151, Sacramento, CA 95821 | 2018-11-27 |
| 1386123438 | Rene William Villanueva | Marriage & Family Therapist | 3650 Auburn Blvd Bldg C-208, Sacramento, CA 95821 | 2018-08-09 |
| 1558853135 | Behavioral Health Solutions of The Pacific | Clinic/Center | 2829 Watt Avenue, Suite 200, Sacramento, CA 95821 | 2018-05-31 |
| 1679064091 | Carrissa Jean Angelique Bishop | Counselor | 3550 Watt Avenue, Suite 140, Sacramento, CA 95821 | 2018-05-21 |
| 1164943049 | Vanessa Selene Tinajero | Social Worker | 3615 Macorni Ave, Sacramento, CA 95821 | 2017-06-30 |
| 1316488562 | Lucas Hansen | Student in an Organized Health Care Education/Training Program | 3007 Clairidge Oak Ct, Sacramento, CA 95821 | 2017-03-20 |
| 1215383054 | Mark Brufladt | Physical Therapy Assistant | 3548 Ardmore Rd, Sacramento, CA 95821 | 2016-05-11 |
| 1053782789 | Marianna Jakucska | Marriage & Family Therapist | 2740 Fulton Ave Ste 100c, Sacramento, CA 95821 | 2015-10-07 |
| Find all providers in zip 95821 | ||||
| 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 | 95821 |
Please comment or provide details below to improve the information on WELLSPACE HEALTH.
| 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.