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KAISER FOUNDATION HOSPITAL HOME HEALTH SANTA ROSA
NPI 1104996933
Home Health in Santa Rosa, CA

Active since November 09, 2006CLIA 05D0972728 · Waiver
3550 ROUND BARN BLVD STE 112, SANTA ROSA, CA 95403(707) 566-5488 Get Directions Write a Review

NPPES record last updated: April 22, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kaiser Foundation Hospital Home Health Santa Rosa NPPES

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

KAISER FOUNDATION HOSPITAL HOME HEALTH SANTA ROSA (NPI 1104996933) is a healthcare organization registered as a home health in Santa Rosa, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through April 13, 2028 and lists Judith L Coffey, Senior Vice President, Area Manager, as its authorized official.

NPPES Registry Identity

NPI1104996933
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameKAISER FOUNDATION HOSPITALS
Location Address3550 ROUND BARN BLVD STE 112Santa Rosa, CA 95403-1796
Mailing Address3550 Round Barn Blvd Ste 112Santa Rosa, CA 95403-1796 · (707) 566-5488 · Fax (707) 566-5702
Phone(707) 566-5488
Organization SubpartNo
Authorized OfficialJudith L CoffeySenior Vice President, Area Manager · (797) 571-4222
Enumeration DateNovember 9, 2006
Last NPPES UpdateApril 22, 2021
NPPES CertifiedApril 22, 2021
✔ NPI 1104996933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in CA · 010000259
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
3550 ROUND BARN BLVD STE 112, Santa Rosa, CA 95403
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Other Names 1

Doing Business AsKaiser Foundation Hospital Home Health Santa Rosa

CLIA Laboratory Certificates CMS CLIA

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 05D0972728

Kaiser Foundation Home Health Santa Rosa · Santa Rosa, CA
Active · expires Apr 13, 2028
CLIA Number05D0972728
Laboratory TypeHome Health Agency
Certificate Effective DateApril 14, 2026
Certificate Expiration DateApril 13, 2028
Laboratory DirectorPhong T. Nguyen
Laboratory Phone(707) 566-5488
Laboratory LocationKaiser Foundation Home Health Santa Rosa3550 Round Barn Blvd, Santa Rosa, CA 95403
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

BRETT THOMAS RIESCHL
Physical Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (707) 566-5269
DAMIEN MICHAEL BRUNNER P.T.
Physical Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (707) 566-5488
MRS. HEATHER LEA MASSIE PT
Physical Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (707) 566-5488
SUZANNE EDWARDS PT
Physical Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (707) 566-5488
TERESA LIN FRY
Occupational Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (707) 566-5488
DR. JOHN ANDREW WESTHAFER PT
Physical Therapist
3550 ROUND BARN BLVD STE 112
SANTA ROSA, CA 95403
Sonoma County (209) 641-5699

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 Kaiser Foundation Hospitals's NPI number?

The NPI number for Kaiser Foundation Hospitals is 1104996933. It was assigned to this organization in the NPPES registry on November 9, 2006. The provider is doing business as Kaiser Foundation Hospital Home Health Santa Rosa.

Where is Kaiser Foundation Hospitals located?

Kaiser Foundation Hospitals is located at 3550 Round Barn Blvd Ste 112, Santa Rosa, CA 95403. The listed phone number is (707) 566-5488.

What is Kaiser Foundation Hospitals's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Kaiser Foundation Hospitals hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0972728) is associated with this NPI, valid through April 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kaiser Foundation Hospitals was last updated on April 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.