WELLSPACE HEALTH
NPI 1104210608
Clinic/Center - Federally Qualified Health Center (FQHC) in Sacramento, CA

Active since March 23, 2015CLIA Certified · 2 labs
3535 65TH ST, SUITE C, SACRAMENTO, CA 95820(916) 737-5555(916) 444-5620 Get Directions Write a Review

NPPES record last updated: August 16, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellspace Health NPPES

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

WELLSPACE HEALTH (NPI 1104210608) is a healthcare organization registered as a federally qualified health center (fqhc) in Sacramento, California and active in the NPI registry since March 2015. The organization holds 2 active CLIA laboratory certificates and lists Alasdair Jonathan Porteus, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1104210608
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameWELLSPACE HEALTH
Location Address3535 65TH ST, SUITE CSacramento, CA 95820-2057
Mailing Address1820 J StreetSacramento, CA 95811 · (916) 550-5481 · Fax (916) 822-8974
Fax(916) 444-5620
Organization SubpartNo
Authorized OfficialAlasdair Jonathan PorteusChief Executive Officer · (916) 737-5555
Enumeration DateMarch 23, 2015
Last NPPES UpdateAugust 16, 2017
NPI 1104210608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
3535 65TH ST, Sacramento, CA 95820

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 of Waiver 05D2063286

Wellspace Health Martin Luther King Jr Village · Sacramento, CA
Active · expires Jul 30, 2027
CLIA Number05D2063286
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorJanine Bera MD
Laboratory Phone(916) 550-5481
Laboratory LocationWellspace Health Martin Luther King Jr Village3900 47th Ave., Sacramento, CA 95824
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2063284

Wellspace Health Boulevard Court · Sacramento, CA
Active · expires Jul 30, 2027
CLIA Number05D2063284
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorJanine Bera MD
Laboratory Phone(916) 704-3573
Laboratory LocationWellspace Health Boulevard Court5321 Stockton Blvd, Sacramento, CA 95820
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Clinic/Center
3535 65TH ST
SACRAMENTO, CA 95820

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 Wellspace Health's NPI number?

The NPI number for Wellspace Health is 1104210608. It was assigned to this organization in the NPPES registry on March 23, 2015.

Where is Wellspace Health located?

Wellspace Health is located at 3535 65th St Suite C, Sacramento, CA 95820. The listed phone number is (916) 737-5555.

What is Wellspace Health's specialty?

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

Does Wellspace Health 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.

When was this NPI record last updated?

The NPPES record for Wellspace Health was last updated on August 16, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.