WEST COUNTY HEALTH CENTERS, INC. (NPI# 1861809501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861809501 |
| Entity Type | Organization |
| Organization Name | WEST COUNTY HEALTH CENTERS, INC. |
| Other Organization Name | GRAVENSTEIN COMMUNITY HEALTH CENTER |
| Practice Address |
652 Petaluma Ave Sebastopol CA 95472-4256 |
| Mailing Address |
Po Box 1449 Guerneville CA 95446-1449 |
| Practice Telephone | 7078695977 |
| Practice Fax Number | 7078695976 |
| Mailing Telephone | 7078695977 |
| Mailing Fax Number | 7078695976 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2014-12-04 |
| Authorized Official Name | MS. MARY E SZECSEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7078691594 |
| 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 |
|---|---|
| Gravenstein Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1356344758 | West County Health Centers, Inc. | Clinic/Center | 16319 Third Street, Guerneville, CA 95446 | 2005-05-31 |
| 1215488705 | West County Health Centers, Inc. | Clinic/Center | 16312 Third St, Guerneville, CA 95446 | 2016-10-19 |
| 1659630036 | West County Health Centers, Inc. | Clinic/Center | 6550 Front Street, Forestville, CA 95436-0000 | 2012-05-07 |
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
| 1598768962 | West County Health Centers, Inc. | Clinic/Center | 3802 Main Street, Occidental, CA 95464 | 2005-05-31 |
| Street Address |
652 PETALUMA AVE |
| City | SEBASTOPOL |
| State | CA |
| Zip Code | 95472-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962401463 | Misty Michelle Zelk | Internal Medicine | 652 Petaluma Ave, Suite H, Sebastopol, CA 95472-4256 | 2005-07-18 |
| 1275016230 | Connie Alejandrina Moreno | Nurse Practitioner | 652 Petaluma Ave, Sebastopol, CA 95472-4256 | 2018-09-14 |
| 1114382751 | Shelleen E Denno Md Inc. | Internal Medicine | 652 Petaluma Ave, Suite D, Sebastopol, CA 95472-4256 | 2015-12-28 |
| 1902244528 | Prima Medical Foundation | General Practice | 652 Petaluma Ave, Suite H, Sebastopol, CA 95472-4256 | 2013-06-05 |
| 1336496710 | Emilio Licea IIi | Psychologist | 652 Petaluma Ave, Sebastopol, CA 95472-4256 | 2012-08-05 |
| 1154590958 | Prima Medical Foundation Sebastopol | Clinic/Center | 652 Petaluma Ave, Suite H, Sebastopol, CA 95472-4256 | 2008-02-26 |
| 1184845182 | Northern California Medical Assoc Inc | Internal Medicine | 652 Petaluma Ave, Ste E, Sebastopol, CA 95472-4266 | 2007-05-01 |
| 1871665471 | Scott Benstock | Dentist | 652 Petaluma Ave, Suite A, Sebastopol, CA 95472-4256 | 2006-11-15 |
| 1992889067 | Allan L. Bernstein | Psychiatry & Neurology | 652 Petaluma Ave, Suite H, Sebastopol, CA 95472-4256 | 2006-10-25 |
| 1497842835 | Sutter Medical Group of The Redwoods | Obstetrics & Gynecology | 652 Petaluma Ave, Suite F, Sebastopol, CA 95472-4256 | 2006-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558916791 | Mellisa Nicole Elrod | Occupational Therapist | 1935 Gravenstein Hwy, Sebastopol, CA 95472 | 2019-08-05 |
| 1457820987 | Isabel Brooke Martinez | Acupuncturist | 961 Gravenstein Hwy South, # 100, Sebastopol, CA 95472 | 2018-11-14 |
| 1275025470 | Shahbano Syeda | Specialist/Technologist | 846/848 Gravenstein Hwy South, Sebastopol, CA 95472 | 2018-06-04 |
| 1467990812 | Mathew Metzgar | Marriage & Family Therapist | 1800 N. Gravenstein Hwy, Sebastopol, CA 95472 | 2017-02-06 |
| 1760939318 | Andrea Kirk | Psychologist | 876 Gravenstein Hwy S., Suite 6, Sebastopol, CA 95472 | 2016-09-01 |
| 1548629371 | Stacy Simons | Massage Therapist | 103 Morris St Ste V, Sebastopol, CA 95472 | 2016-02-22 |
| 1619341880 | Carol Schmid | Counselor | 1800 N, Gravenstein Hwy, Sebastopol, CA 95472 | 2015-11-25 |
| 1801273727 | Aaron Martinez | Specialist/Technologist | 7441 Witter Road, Sebastopol, CA 95472 | 2015-04-29 |
| 1699167049 | Nia Kaye | Marriage & Family Therapist | 130 Petaluma Ave Ste 2c, Sebastopol, CA 95472 | 2015-02-23 |
| 1497091383 | Caitlin Marie Kirkman | Midwife | 5611 Hessel Ave, Sebastopol, CA 95472 | 2012-12-20 |
| Find all providers in zip 95472 | ||||
| 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 |
|---|---|---|---|---|
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
| 1699721209 | East Central Mississippi Health Care Inc | Clinic/Center | 1488 Hwy 487, Sebastopol, MS 39359 | 2006-05-25 |
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| Find all providers with the same taxonomy | ||||
| City | SEBASTOPOL |
| Zip Code | 95472 |
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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.