SANTA ROSA COMMUNITY HEALTH CENTERS – NPI #1386712065
Clinic/Center

SANTA ROSA COMMUNITY HEALTH CENTERS is an AHC clinic located in SANTA ROSA, CA. NPPES has assigned the NPI number 1386712065 to SANTA ROSA COMMUNITY HEALTH CENTERS on December 01, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is SOUTHWEST COMMUNITY HEALTH CENTER. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 3 years ago on Dec 09, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SANTA ROSA COMMUNITY HEALTH CENTERS below.

NPI Profile for
SANTA ROSA COMMUNITY HEALTH CENTERS

NPI Number
1386712065
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Former Legal Business Name: SOUTHWEST COMMUNITY HEALTH CENTER
Other name(s)
All associated names:
Doing Business As (dba)
Lombardi Campus
Former Legal Business Name
Southwest Community Health Center
Primary location
751 LOMBARDI COURT
SANTA ROSA, CA 95407-6798
Phone: (707) 547-2222 Fax: (707) 527-0472
Mailing address
3569 ROUND BARN CIRCLE
SANTA ROSA, CA 95403-5781
Phone: (707) 303-3600 Fax: (707) 303-3635
Organization Subpart
No
Authorized Official
GABRIELA BERNAL-LEROI
CHIEF EXECUTIVE OFFICER
Phone: (707) 303-3600
Updated
Certification Date
Dec 09, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for SANTA ROSA COMMUNITY HEALTH CENTERS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidCAFHC70663F
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
CA 110000300

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.