PEACH TREE CLINIC
NPI 1003863622
Clinic/Center - Federally Qualified Health Center (FQHC) in Marysville, CA
NPI Status: Active since May 28, 2006
Contact Information
5730 PACKARD AVE
SUITE 500
MARYSVILLE, CA
ZIP 95901
Phone: (530) 749-3242
Fax: (530) 749-3238
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- Accepts Insurance
- CLIA Number: 05D0892413
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 09-28-2026
About PEACH TREE CLINIC
This page provides the complete NPI Profile along with additional information for Peach Tree Clinic, a primary care provider established in Marysville, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1003863622 assigned on May 2006. The practitioner's primary taxonomy code is 261QF0400X with license number 550000005 (CA). The provider is registered as an organization and their NPI record was last updated 4 years ago. Peach Tree Clinic operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Peach Tree Clinic. The authorized official of this NPI record is Mr. Greg Stone (Ceo)
- NPI
- 1003863622
- Provider Legal Name
- PEACH TREE HEALTHCARE
- Other Organization Name
- PEACH TREE CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 5730 PACKARD AVE SUITE 500 MARYSVILLE, CA 95901
- Location Phone
- (530) 749-3242
- Location Fax
- (530) 749-3238
- Mailing Address
- 1114 YUBA ST STE 220 MARYSVILLE, CA 95901
- Mailing Phone
- (530) 749-3242
- Mailing Fax
- (530) 749-3238
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-28-2006
- Last Update Date
- 05-23-2022
- Code Navigator
A primary care provider (PCP) like Peach Tree Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License No.
- 550000005
- License State
- CA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | PSY10876 (CA) |
| 2 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | LCS12778 (CA) |
| 3 | 152W00000X | Eye and Vision Services Providers | Optometrist | 14503TLG (CA) |
| 4 | 171100000X | Other Service Providers | Acupuncturist | A66235 (CA) |
| 5 | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
| 6 | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | A368140 (CA) |
| 7 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | A93985 (CA) |
| 8 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | A104819 (CA) |
| 9 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | A60310 (CA) |
| 10 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | G42749 (CA) |
| 11 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | 2OA5572 (CA) |
| 12 | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | E1137 (CA) |
| 13 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | PA14393 (CA) |
| 14 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 18608 (CA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Lone Star - Smile Now - PPO
- Smile Now Arizona - No Waiting Period PPO - PPO
- Smile Now Michigan - No Waiting Period PPO - PPO
- Smile Now Ohio - No Waiting Period PPO - PPO
- Smile Now Texas- No Waiting Period Plan - PPO
- Smile Now Utah - No Waiting Period PPO - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| FHC11619G | MEDICAID (05) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0892413
- Facility Type
- Community Clinic
- Certificate Effective Date
- September 29, 2024
- Certificate Expiration Date
- September 28, 2026
- Laboratory Director
- MARY ROSALIE PENA-PRIDMORE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Peach Tree Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PEACH TREE CLINIC
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003863622, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
MARYSVILLE, CA 95901
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003863622, enumerated as an "organization" on May 28, 2006.
The provider is located at 5730 PACKARD AVE SUITE 500 MARYSVILLE, CA 95901 and the phone number is (530) 749-3242.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
