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PEACH TREE CLINIC
NPI 1003863622
Clinic/Center - Federally Qualified Health Center (FQHC) in Marysville, CA

Active since May 28, 2006CLIA Certified · 2 labs
5730 PACKARD AVE, SUITE 500, MARYSVILLE, CA 95901(530) 749-3242(530) 749-3238 Get Directions Write a Review

NPPES record last updated: May 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 23, 2022, Jun 29, 2017 (2 updates tracked since 2017).

About Peach Tree Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEACH TREE CLINIC (NPI 1003863622) is a healthcare organization registered as a federally qualified health center (fqhc) in Marysville, California and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates and lists Greg Stone, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003863622
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NamePEACH TREE HEALTHCARE
Location Address5730 PACKARD AVE, SUITE 500Marysville, CA 95901-7118
Mailing Address1114 Yuba St Ste 220Marysville, CA 95901-4838 · (530) 749-3242 · Fax (530) 749-3248
Phone(530) 749-3242
Fax(530) 749-3238
Organization SubpartNo
Authorized OfficialGreg StoneCeo · (530) 741-6245
Enumeration DateMay 28, 2006
Last NPPES UpdateMay 23, 20222 updates tracked since enumeration
NPPES CertifiedMay 23, 2022
✔ NPI 1003863622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in CA · 550000005
Also ListedPsychologistTaxonomy 103T00000X · License PSY10876 (CA)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License LCS12778 (CA)
Also ListedOptometristTaxonomy 152W00000X · License 14503TLG (CA)
Also ListedAcupuncturistTaxonomy 171100000X · License A66235 (CA)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License A368140 (CA)
Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License A93985 (CA)
Also ListedOphthalmologyTaxonomy 207W00000X · License A104819 (CA)
Also ListedPediatricsTaxonomy 208000000X · License A60310 (CA)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License G42749 (CA)
Also ListedGeneral PracticeTaxonomy 208D00000X · License 2OA5572 (CA)
Also ListedPodiatristTaxonomy 213E00000X · License E1137 (CA)
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA14393 (CA)
Also ListedNurse PractitionerTaxonomy 363L00000X · License 18608 (CA)
5730 PACKARD AVE, Marysville, CA 95901
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Other Names 1

Doing Business AsPeach Tree Clinic

Other Identifiers 1

MedicaidFHC11619GCA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0684018

Peach Tree Clinic Laboratory · Marysville, CA
Active · expires Sep 12, 2027
CLIA Number05D0684018
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorGina Rossetti
Laboratory Phone(530) 741-6245
Laboratory LocationPeach Tree Clinic Laboratory5730 Packard Ave Ste 600, Marysville, CA 95901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 05D0892413

Peach Tree Clinic Dba Live Oak Medical Clinic · Live Oak, CA
Active · expires Sep 28, 2026
CLIA Number05D0892413
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 29, 2024
Certificate Expiration DateSeptember 28, 2026
Laboratory DirectorMary Rosalie Pena-Pridmore
Laboratory Phone(530) 749-3242
Laboratory LocationPeach Tree Clinic Dba Live Oak Medical Clinic9980 Live Oak Blvd, Live Oak, CA 95953
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELA K FRENCH BSN, RN, PHN
Registered Nurse (Case Management)
5730 PACKARD AVE, SUITE 100
MARYSVILLE, CA 95901
Yuba County (530) 749-6454
ROCHELLE BOQUIREN FINNEGAN RN
Case Manager/Care Coordinator
5730 PACKARD AVE
MARYSVILLE, CA 95901
Yuba County (530) 749-6352
ANN SOLIDAY R.N.
Registered Nurse (Community Health)
5730 PACKARD AVE
MARYSVILLE, CA 95901
Yuba County (530) 749-6785
LYNNE CIULLO OLSEN PHN
Registered Nurse
5730 PACKARD AVE, STE 100
MARYSVILLE, CA 95901
Yuba County (530) 749-6766
MRS. MARY JOAN SCHMIERER RN
Registered Nurse
5730 PACKARD AVE, SUITE 100
MARYSVILLE, CA 95901
Yuba County (530) 749-6311
KIMBERLY-ANN AGCOPRA RN, PHN, BSN
Registered Nurse (Case Management)
5730 PACKARD AVE, SUITE 100
MARYSVILLE, CA 95901
Yuba County (530) 749-6366
SARAH JANE HAWKINS R.N.
Registered Nurse (General Practice)
5730 PACKARD AVE
MARYSVILLE, CA 95901
Yuba County (530) 749-6366
MRS. ROSARIO MELINDA T. MCGEORGE BSN, RN, PHN
Registered Nurse (Case Management)
5730 PACKARD AVE, SUITE 100
MARYSVILLE, CA 95901
Yuba County (530) 749-6406

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peach Tree Healthcare's NPI number?

The NPI number for Peach Tree Healthcare is 1003863622. It was assigned to this organization in the NPPES registry on May 28, 2006. The provider is doing business as Peach Tree Clinic.

Where is Peach Tree Healthcare located?

Peach Tree Healthcare is located at 5730 Packard Ave Suite 500, Marysville, CA 95901. The listed phone number is (530) 749-3242.

What is Peach Tree Healthcare's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Peach Tree Healthcare hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Peach Tree Healthcare accept?

Health plans from UnitedHealthcare list Peach Tree Healthcare as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Peach Tree Healthcare was last updated on May 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.