Organization · Type 2 NPI

Petaluma Health Center, Inc

Federally Qualified Health Center (FQHC) · Petaluma, CA

NPI number 1588422604 Active

Practice location

900 Hopper St
Petaluma, CA 94952-3388

Call (707) 559-7500 Map

Mailing address

1455 N Mcdowell Blvd Ste D
Petaluma, CA 94954-6503

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

California Human Development CorporationSubstance Abuse Rehabilitation Facility Petaluma, CA NPI 1023567427
Committee On the ShelterlessSupports Brokerage Agency Petaluma, CA NPI 1497410286

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NPI record

NPI: 1588422604
Entity type: Organization (Type 2)
Issued: Mar 12, 2024
Last updated: Apr 22, 2024
Status: Active

Other names

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Mary Isaak Center Clinic · doing business as
Mary Isaak Homeless Shelter Clinic · doing business as

Authorized official

Molly Jouaneh
CFO
(707) 559-7500

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1588422604

Petaluma Health Center, Inc's National Provider Identifier is 1588422604, issued on Mar 12, 2024. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Petaluma, CA. The record was last updated on Apr 22, 2024.