UKIAH ADVENTIST HOSPITAL (NPI# 1952471542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952471542 |
| Entity Type | Organization |
| Organization Name | UKIAH ADVENTIST HOSPITAL |
| Other Organization Name | ADVENTIST HEALTH UKIAH VALLEY |
| Practice Address |
260 Hospital Drive Suite 207 Ukiah CA 95482-6353 |
| Mailing Address |
Po Box 398867 San Francisco CA 94139-8867 |
| Practice Telephone | 7074638020 |
| Practice Fax Number | 7074621111 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | RYAN QUATTLEBAUM (CFO) |
| Authorized Official Telephone | 7074637360 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
110000095 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | HSP40301F | 05 |
| Other Name | Type Code |
|---|---|
| Adventist Health Ukiah Valley | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588095848 | Ukiah Adventist Hospital | Clinic/Center | 850 Sequoia Cir, Fort Bragg, CA 95437-5490 | 2013-12-11 |
| 1770653362 | Ukiah Adventist Hospital | Clinic/Center | 1050 N State St, Ukiah, CA 95482-3414 | 2006-11-09 |
| 1174583504 | Ukiah Adventist Hospital | Allergy & Immunology | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2006-03-28 |
| 1235120676 | Ukiah Adventist Hospital | Allergy & Immunology | 275 Hospital Dr, Ukiah, CA 95482-4531 | 2005-11-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | UKIAH ADVENTIST HOSPITAL | 275 Hospital Drive, Ukiah, CA 95482 |
| Street Address |
260 HOSPITAL DRIVE SUITE 207 |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-6353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780754374 | Ukiah Adventist Hosptial | Clinic/Center | 1165 S Dora St, Suite B-1, Ukiah, CA 95482-8325 | 2006-11-09 |
| 1861562456 | Ukiah Adventist Hosptial | Clinic/Center | 1165 S Dora St, Suite E-2, Ukiah, CA 95482-8325 | 2006-11-09 |
| 1770653362 | Ukiah Adventist Hospital | Clinic/Center | 1050 N State St, Ukiah, CA 95482-3414 | 2006-11-09 |
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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.