Organization · Type 2 NPI

Providence Medical Foundation

Family Medicine Physician · Santa Rosa, CA

NPI number 1265015978 Active

Practice location

185 Sotoyome St
Santa Rosa, CA 95405-4803

Call (707) 303-8355 Map

Fax (707) 303-2035

Mailing address

PO Box 31001 - 1920
Pasadena, CA 91110-1920

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1265015978

Providence Medical Foundation's National Provider Identifier is 1265015978, issued on Apr 30, 2021. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Santa Rosa, CA. The record was last updated on Jan 6, 2026.