ST JOSEPH HERITAGE HEALTHCARE


Address: 500 Doyle Park Dr, Suite 303, Santa Rosa, CA 95405-4558
Phone: 7073038300

ST JOSEPH HERITAGE HEALTHCARE (NPI# 1740584473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740584473
Entity Type Organization
Organization Name ST JOSEPH HERITAGE HEALTHCARE
Other Organization Name ST JUDE HOSPITAL YORBA LINDA
Practice Address 500 Doyle Park Dr
Suite 303
Santa Rosa
CA 95405-4558
Mailing Address 200 W Center Street Promenade
Suite 400
Anaheim
CA 92805-3960
Practice Telephone 7073038300
Practice Fax Number 7073038301
Mailing Telephone 7144494800
Mailing Fax Number 7144494956
Enumeration Date 2011-01-10
Last Update Date 2017-09-11
Authorized Official Name JOHN BENNETT (CHIEF ADMINISTRATIVE OFFICER)
Authorized Official Telephone 7149377018
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
St Jude Hospital Yorba Linda Former Legal Business Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1770068629 St Joseph Heritage Healthcare Family Medicine 1 Edwards Way, Irvine, CA 92614-5688 2018-09-26
1609925957 St Joseph Heritage Healthcare Family Medicine 500 S Main St Ste 1000, Orange, CA 92868-4533 2007-01-09
1639715709 St Joseph Heritage Healthcare Family Medicine 200 W Center Street Promenade, Anaheim, CA 92805-3960 2019-11-22
1801443510 St Joseph Heritage Healthcare Internal Medicine 1010 W La Veta Ave Ste 200, Orange, CA 92868-4301 2019-08-19
1427305960 St Joseph Heritage Healthcare Physical Medicine & Rehabilitation 26522 La Alameda, Suite 120, Mission Viejo, CA 92691-6330 2012-08-14
1649551086 St Joseph Heritage Healthcare Anesthesiology 2700 Dolbeer St, Eureka, CA 95501-4736 2011-08-30
1386937225 St Joseph Heritage Healthcare Durable Medical Equipment & Medical Supplies 2826 Harris St, Eureka, CA 95503-4809 2011-05-25
1316243769 St Joseph Heritage Healthcare Durable Medical Equipment & Medical Supplies 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835 2011-02-02
1205131950 St Joseph Heritage Healthcare Durable Medical Equipment & Medical Supplies 1100 Trancas St, Suite 209, Napa, CA 94558-2900 2011-01-11
1053616706 St Joseph Heritage Healthcare Durable Medical Equipment & Medical Supplies 19333 Bear Valley Rd, Suite 106, Apple Valley, CA 92308-5148 2011-01-11

Office Location

Street Address 500 DOYLE PARK DR
SUITE 303
City SANTA ROSA
State CA
Zip Code 95405-4558

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871599852 David Finnigan Pediatrics 500 Doyle Park Dr, Santa Rosa, CA 95405-4558 2005-06-23
1659807170 Peter Chang-sing, Md Internal Medicine 500 Doyle Park Dr, Suite 302, Santa Rosa, CA 95405-4558 2017-05-03
1255738803 Adventist Health Physicians Network Clinic/Center 500 Doyle Park Dr, Suite 106a, Santa Rosa, CA 95405-4558 2014-11-25
1528481983 Northern California Medical Assoc Inc Obstetrics & Gynecology 500 Doyle Park Dr, Ste 103, Santa Rosa, CA 95405-4559 2014-01-21
1073857439 Allison Cali Paine Pediatrics 500 Doyle Park Dr, Suite 100, Santa Rosa, CA 95405-4558 2012-11-23
1154685121 Jonathan Michael Kurss Obstetrics & Gynecology 500 Doyle Park Dr, Suite 200, Santa Rosa, CA 95405-4558 2012-06-25
1619236452 Northern California Minimally Invasive Cardiovascular Surgery Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) 500 Doyle Park Dr, Suite G-05, Santa Rosa, CA 95405-4558 2012-05-14
1578838298 Jennifer Ellen Johnson Byer Obstetrics & Gynecology 500 Doyle Park Dr, Suite G06, Santa Rosa, CA 95405-4558 2012-03-13
1023397155 Cynthia R. Ingels Nurse Practitioner 500 Doyle Park Dr, Suite 103, Santa Rosa, CA 95405-4558 2011-08-07
1598051575 Dina Vaynberg Obstetrics & Gynecology 500 Doyle Park Dr, Santa Rosa, CA 95405-4558 2011-06-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083230486 Lizett Camacho Counselor 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 2020-06-22
1346768918 Ingrid Tsong Student in an Organized Health Care Education/Training Program 3447 Summerfield Road, Santa Rosa, CA 95405 2017-09-05
1275051898 Jessica Peters Malmberg Student in an Organized Health Care Education/Training Program 2447 Summerfield Rd, Santa Rosa, CA 95405 2017-09-04
1306246772 Kirsten Eckert Advanced Practice Midwife 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 2014-09-03
1982034294 Mohammad Reza Saeidi Dentist 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 2013-11-22
1851631642 Debi M. Emmons Marriage & Family Therapist 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 2013-02-15
1841549979 Karie Louise Klim Marriage & Family Therapist 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 2012-09-05
1427314400 Rachel E. Page Counselor 2447 Summerfield Rd., Santa Rosa, CA 95405 2012-04-04
1689991572 Center for Integral Healing Inc. Community Health Worker 182 Farmers Lane, #203, Santa Rosa, CA 95405 2010-04-30
1588997647 Kai Morgan Dentist 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 2009-09-08
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1922640820 Northern California Medical Assoc Inc Internal Medicine 830 2nd St Ste A, Santa Rosa, CA 95404-4620 2019-10-11
1457613275 Shelleen E. Denno, Md, Inc. Internal Medicine 2285 Olivet Ln, Santa Rosa, CA 95401-3860 2012-06-08
1043509920 Ann Katz Press Internal Medicine 30 Mark West Springs Rd Ofc, Santa Rosa, CA 95403-1436 2011-03-31
1376786947 Jaya Reddy Mallidi Internal Medicine 500 Doyle Park Dr Ste G05, Santa Rosa, CA 95405-4555 2009-04-13
1003072851 Sutter Medical Group of The Redwoods Internal Medicine 4725a Hoen Ave, Santa Rosa, CA 95405-7862 2008-07-31
1639355266 North Coast Hospitalist, PC Internal Medicine 122 Calistoga Rd, 305, Santa Rosa, CA 95409-3702 2008-01-14
1932388659 Jennifer Nguyen Hubert, D.o., Inc Internal Medicine 1014 Hopper Ave, # 615, Santa Rosa, CA 95403-1613 2007-10-30
1144412560 Zeyad Hashem Kanaan Internal Medicine 3883 Airway Dr Ste 220, Santa Rosa, CA 95403 2007-08-10
1447451935 Todd Jay Hofeling Internal Medicine 3883 Airway Dr Ste 130, Santa Rosa, CA 95403 2007-05-30
1932244779 John Mcdougall Internal Medicine 2777 4th St, Santa Rosa, CA 95405-4795 2007-02-20
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Competitor

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City SANTA ROSA
Zip Code 95405

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Dataset Information

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.

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