| Mendocino Coast Clinics Inc | |
|
690 S Main St Fort Bragg CA 95437-5108 | |
| (707) 364-1251 | |
| Not Available |
| Full Name | Mendocino Coast Clinics Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 690 S Main St, Fort Bragg, California |
| Authorized Official Name and Position | Lucresha M Renteria (CEO) |
| Authorized Official Contact | 7079641251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendocino Coast Clinics Inc 205 South St Fort Bragg CA 95437-5540 Ph: (707) 364-1251 | Mendocino Coast Clinics Inc 690 S Main St Fort Bragg CA 95437-5108 Ph: (707) 364-1251 |
| NPI Number | 1609595404 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 08/24/2022 |
| Medicare PECOS PAC ID | 5991619157 |
|---|---|
| Medicare Enrollment ID | O20050512001033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609595404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Linnea M Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417174756 PECOS PAC ID: 1557397494 Enrollment ID: I20050712001260 |
| Provider Name | Douglas S Lister |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295958312 PECOS PAC ID: 4284665100 Enrollment ID: I20050830000546 |
| Provider Name | Lawrence M Goldyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780605097 PECOS PAC ID: 1557367588 Enrollment ID: I20061013000269 |
| Provider Name | Barbara J Kilian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306869342 PECOS PAC ID: 0749285815 Enrollment ID: I20090611000433 |
| Provider Name | Jennifer B Kreger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922005586 PECOS PAC ID: 4385781749 Enrollment ID: I20091017000032 |
| Provider Name | Brent Wright |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275657231 PECOS PAC ID: 2062601396 Enrollment ID: I20110118000710 |
| Provider Name | Wade J Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508861782 PECOS PAC ID: 1658551635 Enrollment ID: I20110208000671 |
| Provider Name | Kei J Velazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760581631 PECOS PAC ID: 7517140544 Enrollment ID: I20110329000041 |
| Provider Name | Rebecca S Timme |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780848325 PECOS PAC ID: 3870743594 Enrollment ID: I20121015000534 |
| Provider Name | Cayo Alba |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164718334 PECOS PAC ID: 3072767813 Enrollment ID: I20130204000288 |
| Provider Name | Thomas P Knecht |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1235371857 PECOS PAC ID: 9537112818 Enrollment ID: I20150929001419 |
| Provider Name | Christopher Leonard Robshaw |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932178449 PECOS PAC ID: 9032466370 Enrollment ID: I20180718001913 |
| Provider Name | John Joseph Remington |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538231246 PECOS PAC ID: 7719226984 Enrollment ID: I20190305003531 |
| Provider Name | Jenna Rose Breton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427222538 PECOS PAC ID: 2466778451 Enrollment ID: I20190312000876 |
| Provider Name | James H Young |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1942353875 PECOS PAC ID: 4587091673 Enrollment ID: I20200302002362 |
| Provider Name | Ann K Gallo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891980561 PECOS PAC ID: 2264775345 Enrollment ID: I20200615001994 |
| Provider Name | Genevieve Marilyn Banegas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821340480 PECOS PAC ID: 6305268434 Enrollment ID: I20200618002539 |
| Provider Name | David Todd Stein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104999606 PECOS PAC ID: 3870833403 Enrollment ID: I20210507002240 |
| Provider Name | Crystal Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083267165 PECOS PAC ID: 5991126005 Enrollment ID: I20210827003079 |
| Provider Name | John Alexander-blair Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144793639 PECOS PAC ID: 4385984244 Enrollment ID: I20210928001333 |
| Provider Name | Roshanda Grayson-thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619415874 PECOS PAC ID: 7214342930 Enrollment ID: I20221026000199 |
| Provider Name | Carolyn S Hand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245395219 PECOS PAC ID: 2163694597 Enrollment ID: I20230426001740 |
| Provider Name | Lisa Gay Fredrickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932533924 PECOS PAC ID: 7012356629 Enrollment ID: I20240416001264 |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 850 Sequoia Cir, Fort Bragg, CA 95437 Phone: 707-964-0259 Fax: 707-964-0765 | |
Mendocino Coast Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 South Street, Fort Bragg, CA 95437 Phone: 707-964-1251 Fax: 707-961-2722 | |
Mendocino Coast District Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 721 River Drive, Suite A, Fort Bragg, CA 95437 Phone: 707-961-4631 Fax: 707-964-1192 | |
Adventist Health Medical Specialties Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 721 River Dr, Suite C, Fort Bragg, CA 95437 Phone: 707-463-8000 Fax: 707-462-1111 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 153 W Spruce St, Fort Bragg, CA 95437 Phone: 707-462-1516 Fax: 707-462-1178 | |
Mendocino Coast Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Cypress St Ste C-100, Fort Bragg, CA 95437 Phone: 707-961-3430 | |
Mendocino Coast Clinics, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 Cypress St Ste D, Fort Bragg, CA 95437 Phone: 707-964-5696 |