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WELLSPACE HEALTH
NPI 1114682689
Clinic/Center - Federally Qualified Health Center (FQHC) in Sacramento, CA

Active since November 01, 2021CLIA 05D2329354 · Waiver
4990 STOCKTON BLVD, SACRAMENTO, CA 95820(916) 737-5555 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 10, 2022, Nov 1, 2021 (2 updates tracked since 2021).

About Wellspace Health NPPES

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

WELLSPACE HEALTH (NPI 1114682689) is a healthcare organization registered as a federally qualified health center (fqhc) in Sacramento, California and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through August 26, 2027 and lists Alasdair Jonathan Porteus, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1114682689
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameWELLSPACE HEALTH
Location Address4990 STOCKTON BLVDSacramento, CA 95820-5406
Mailing Address777 12th St Ste 250Sacramento, CA 95814-1929 · (916) 469-4705 · Fax (916) 880-5552
Phone(916) 737-5555
Organization SubpartNo
Authorized OfficialAlasdair Jonathan PorteusChief Executive Officer · (916) 550-5444
Enumeration DateNovember 1, 2021
Last NPPES UpdateMarch 23, 20222 updates tracked since enumeration
NPPES CertifiedMarch 23, 2022
✔ NPI 1114682689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedContractorTaxonomy 171W00000X
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedSupports BrokerageTaxonomy 251X00000X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedHome Delivered MealsTaxonomy 332U00000X
Also ListedTechnician · Personal Care AttendantTaxonomy 3747P1801X
Also ListedRespite CareTaxonomy 385H00000X
4990 STOCKTON BLVD, Sacramento, CA 95820
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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

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 05D2329354

Wellspace Health Placer Community Health Center · Roseville, CA
Active · expires Aug 26, 2027
CLIA Number05D2329354
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 27, 2025
Certificate Expiration DateAugust 26, 2027
Laboratory DirectorJanine Bera
Laboratory Phone(916) 469-4705
Laboratory LocationWellspace Health Placer Community Health Center100 Stonehouse Ct Suite 100, Roseville, CA 95678
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 2

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

COUNTY OF SACRAMENTO
Community/Behavioral Health
4990 STOCKTON BLVD
SACRAMENTO, CA 95820
Sacramento County (916) 874-2407
WENDY WILLIS
Licensed Vocational Nurse
4990 STOCKTON BLVD
SACRAMENTO, CA 95820
Sacramento County (916) 822-8973

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 1114682689. It was assigned to this organization in the NPPES registry on November 1, 2021.

Where is Wellspace Health located?

Wellspace Health is located at 4990 Stockton Blvd, 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 a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2329354) is associated with this NPI, valid through August 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellspace Health was last updated on March 23, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.