| Alexander Valley Healthcare | |
|
6 Tarman Dr Cloverdale CA 95425-3932 | |
| (707) 894-4229 | |
| Not Available |
| Full Name | Alexander Valley Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 6 Tarman Dr, Cloverdale, California |
| Authorized Official Name and Position | Patrick Richards (CONTROLLER) |
| Authorized Official Contact | 7076691780 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Valley Healthcare 106 E 1st St Cloverdale CA 95425-3746 Ph: (707) 669-1780 | Alexander Valley Healthcare 6 Tarman Dr Cloverdale CA 95425-3932 Ph: (707) 894-4229 |
| NPI Number | 1033534466 |
|---|---|
| Provider Enumeration Date | 02/21/2014 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 3274445465 |
|---|---|
| Medicare Enrollment ID | O20031105000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033534466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 110000318 (California) | Primary |
| Provider Name | Jing Zhao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376621862 PECOS PAC ID: 3072571330 Enrollment ID: I20070502000525 |
| Provider Name | James T Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578544755 PECOS PAC ID: 9133209828 Enrollment ID: I20081002000604 |
| Provider Name | Joann Rosenfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215031588 PECOS PAC ID: 3779637236 Enrollment ID: I20090818000387 |
| Provider Name | Patricia A Serio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245261825 PECOS PAC ID: 1254467772 Enrollment ID: I20100408000553 |
| Provider Name | Amy Brom |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861680845 PECOS PAC ID: 7113163205 Enrollment ID: I20130416000254 |
| Provider Name | Gordana Potrebic |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1699960666 PECOS PAC ID: 5092022509 Enrollment ID: I20150916001335 |
| Provider Name | Elizabeth L Pile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881058022 PECOS PAC ID: 6800181546 Enrollment ID: I20160819002132 |
| Provider Name | Marianne L Rickards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306933585 PECOS PAC ID: 4789094228 Enrollment ID: I20201111002796 |
| Provider Name | Donghyun Kim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548614563 PECOS PAC ID: 6305130592 Enrollment ID: I20220719000500 |
Alexander Valley Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Tarman Dr, Cloverdale, CA 95425 Phone: 707-894-4229 Fax: 707-894-2954 | |
Alexander Valley Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Tarman Drive, Cloverdale, CA 95425 Phone: 707-894-4229 Fax: 707-894-2954 | |
Alexander Valley Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 E 1st St, Cloverdale, CA 95425 Phone: 707-894-4229 Fax: 707-894-2954 | |
Alexander Valley Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 W 3rd St, Cloverdale, CA 95425 Phone: 707-894-4229 |