ST JUDE HOSPITAL YORBA LINDA (NPI# 1801254594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801254594 |
| Entity Type | Organization |
| Organization Name | ST JUDE HOSPITAL YORBA LINDA |
| Other Organization Name | ST JOSEPH HERITAGE HEALTHCARE |
| Practice Address |
925 Corporate Cntr Pkwy Suite A Santa Rosa CA 95407-5451 |
| Mailing Address |
200 W Center Street Promenade Ste 400 Anaheim CA 92805-3960 |
| Practice Telephone | 7075432000 |
| Mailing Telephone | 7144494800 |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2016-04-15 |
| Authorized Official Name | TINA MYCROFT (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7149377023 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Joseph Heritage Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780980169 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 24 W El Rose Dr, Petaluma, CA 94952-4023 | 2011-02-02 |
| 1043608805 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 | 2015-01-02 |
| 1831587955 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954-2357 | 2014-12-23 |
| 1376963314 | St Jude Hospital Yorba Linda | Internal Medicine | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 | 2014-04-17 |
| 1700214913 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2141 N Harbor Blvd, Suite 25000, Fullerton, CA 92835-3827 | 2013-10-25 |
| 1053617076 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 4750 Hoen Ave, Santa Rosa, CA 95405-7833 | 2011-02-09 |
| 1942506969 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 4900 Prospect Ave, Suite 180, Yorba Linda, CA 92886-2128 | 2011-02-09 |
| 1679879696 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2720 N Harbor Blvd, Suite 200, Fullerton, CA 92835-2609 | 2011-02-09 |
| 1588960504 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2720 N Harbor Blvd, Suite 220, Fullerton, CA 92835-2609 | 2011-02-09 |
| 1396041315 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2720 N Harbor Blvd, Suite 300, Fullerton, CA 92835-2609 | 2011-02-09 |
| Street Address |
925 CORPORATE CNTR PKWY SUITE A |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-5451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184173239 | Constance Dougherty | Emergency Medicine | 452 Pythian Rd, Santa Rosa, CA 95409-6349 | 2016-09-30 |
| 1194074542 | John Daniel Spenst | Emergency Medicine | 607 Cherry St, Santa Rosa, CA 95404-4202 | 2012-08-30 |
| 1730235540 | Jason Smith Day | Emergency Medicine | 301 Breeden St, Santa Rosa, CA 95409 | 2007-01-25 |
| 1427157262 | Dawn H. Magdalin-betts | Emergency Medicine | 3250 Oak Farm Ln, Santa Rosa, CA 95401-4046 | 2006-09-21 |
| 1669416285 | Gary Mc Calla | Emergency Medicine | 1165 Montgomery Drive, Santa Rosa Memorial Hospital, Santa Rosa, CA 95405-4897 | 2006-06-15 |
| 1144261637 | Stephen R Levinson | Emergency Medicine | Santa Rosa Memorial Hospital, 1165 Montgomery Drive, Santa Rosa, CA 95405-4897 | 2006-06-08 |
| 1346224292 | Edward Wilhelm Hard Jr. | Emergency Medicine | 3854 Rocky Point Way, Santa Rosa, CA 95404-7606 | 2005-12-05 |
| 1528512688 | Sutter Bay Medical Foundation | Emergency Medicine | 3883 Airway Dr, Suite 120, Santa Rosa, CA 95403-1670 | 2016-08-06 |
| 1033555024 | Christina Marie Goodwin | Emergency Medicine | 1165 Montgomery Dr, M/s 1w04, Santa Rosa, CA 95405-4801 | 2013-05-16 |
| 1225387152 | Sonali Patel | Emergency Medicine | 1165 Montgomery Dr, Santa Rosa, CA 95405 | 2012-09-06 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
Please comment or provide details below to improve the information on ST JUDE HOSPITAL YORBA LINDA.
| 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.