ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Complete NPI Record 1154467009
Specialist in Saint Helena, CA

Active since January 29, 2007
1001 ADAMS ST, SUITE 102, SAINT HELENA, CA 94574(707) 968-2809(707) 963-9185 Get Directions

NPPES record last updated: April 28, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Complete NPI Dataset

This page contains the complete raw NPPES record for Adventist Health California Medical Group, Inc. (NPI 1154467009), a specialist organization in Saint Helena, CA. All 32 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

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Registry File Document Utilities
NPI: 1154467009
Field 1/32
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/32
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/32
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Field 4/32
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1001 ADAMS ST
Field 5/32
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing Address: SUITE 102
Field 6/32
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City Name: SAINT HELENA
Field 7/32
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: CA
Field 8/32
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 945741107
Field 9/32
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 10/32
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 7079682809
Field 11/32
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 7079639185
Field 12/32
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 1001 ADAMS ST
Field 13/32
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 102
Field 14/32
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SAINT HELENA
Field 15/32
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
Field 16/32
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 945741107
Field 17/32
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 18/32
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7079682809
Field 19/32
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7079639185
Field 20/32
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: DONNELLY
Field 23/32
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: KAYE
Field 24/32
The first name of the authorized official.
Authorized Official Middle Name: A.
Field 25/32
The middle name of the authorized official.
Authorized Official Title or Position: SPECIALIST CONTRACT COMPLIANCE
Field 26/32
The title or position of the authorized official.
Authorized Official Telephone Number: 7079682809
Field 27/32
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 174400000X
Field 28/32
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 29/32
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Field 30/32
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
Authorized Official Name Prefix Text: MS.
Field 31/32
The prefix used in the name of the authorized official associated with the provider's NPI record. Examples include Mr., Ms., Mrs., Dr., or other common professional or personal prefixes.
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Field 32/32
Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
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