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PROVIDENCE MEDICAL FOUNDATION
NPI 1053616706
Urology in Apple Valley, CA

Active since January 11, 2011
19333 BEAR VALLEY RD, SUITE 106, APPLE VALLEY, CA 92308(760) 240-5505(760) 245-5525 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 1, 2025, Mar 17, 2025, May 5, 2021 and 1 more (4 updates tracked since 2017).

About Providence Medical Foundation NPPES

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

PROVIDENCE MEDICAL FOUNDATION (NPI 1053616706), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as an urology in Apple Valley, California and active in the NPI registry since January 2011. The organization lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1053616706
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address19333 BEAR VALLEY RD, SUITE 106Apple Valley, CA 92308-5148
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800 · Fax (714) 449-4956
Phone(760) 240-5505
Fax(760) 245-5525
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateJanuary 11, 2011
Last NPPES UpdateDecember 1, 20254 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1053616706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
19333 BEAR VALLEY RD, Apple Valley, CA 92308
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Other Names 2

Former Legal Business NameSt Joseph Heritage Healthcare
Former Legal Business NameSt Jude Hospital Yorba Linda

Other Providers at the Same Location NPPES 12

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

KATHERINE H SHIELDS FNP-C
Nurse Practitioner (Family)
19333 BEAR VALLEY RD
APPLE VALLEY, CA 92308
San Bernardino County (760) 956-8700
MRS. YOLANDA M BURNETT-BATTLE FNP
Nurse Practitioner (Family)
19333 BEAR VALLEY RD, SUITE 201
APPLE VALLEY, CA 92308
San Bernardino County (760) 956-8700
FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY OF THE HIGH DESERT
Obstetrics & Gynecology (Gynecology)
19333 BEAR VALLEY RD, SUITE 106
APPLE VALLEY, CA 92308
San Bernardino County (760) 946-5177
HIGH DESERT SPECIALTY GROUP
Podiatrist (Foot & Ankle Surgery)
19333 BEAR VALLEY RD, SUITE 101
APPLE VALLEY, CA 92308
San Bernardino County (760) 240-6749
SHATHA BAKIR MD
Family Medicine
19333 BEAR VALLEY RD
APPLE VALLEY, CA 92308
San Bernardino County (760) 240-3784
COLLEEN MARY SNYDER F.N.P.
Nurse Practitioner (Pediatrics)
19333 BEAR VALLEY RD
APPLE VALLEY, CA 92308
San Bernardino County (760) 241-6666
ST JUDE HOSPITAL YORBA LINDA
Orthopaedic Surgery
19333 BEAR VALLEY RD, SUITE 104
APPLE VALLEY, CA 92308
San Bernardino County (760) 247-8462
MRS. ARLINA VANESSA FAUSTO BSN-RN
Registered Nurse
19333 BEAR VALLEY RD
APPLE VALLEY, CA 92308
San Bernardino County (760) 241-6666

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 Providence Medical Foundation's NPI number?

The NPI number for Providence Medical Foundation is 1053616706. It was assigned to this organization in the NPPES registry on January 11, 2011. The provider was formerly known as St Joseph Heritage Healthcare and St Jude Hospital Yorba Linda.

Where is Providence Medical Foundation located?

Providence Medical Foundation is located at 19333 Bear Valley Rd Suite 106, Apple Valley, CA 92308. The listed phone number is (760) 240-5505.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.