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PEACH TREE NORTH SACRAMENTO
NPI 1164886040
Clinic/Center - Federally Qualified Health Center (FQHC) in Sacramento, CA

Active since April 07, 2016CLIA 05D0616752 · Microscopy
3810 ROSIN CT, SUITE 100, SACRAMENTO, CA 95834(530) 741-6245(530) 741-9274 Get Directions Write a Review

NPPES record last updated: May 23, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 23, 2022, Jan 11, 2021, Jul 19, 2017 and 1 more (4 updates tracked since 2017).

About Peach Tree North Sacramento NPPES

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

PEACH TREE NORTH SACRAMENTO (NPI 1164886040) is a healthcare organization registered as a federally qualified health center (fqhc) in Sacramento, California and active in the NPI registry since April 2016. The organization holds a CLIA Microscopy certificate valid through November 13, 2027, maintains a secondary practice location in Oroville, and lists Greg S Stone, Ceo, as its authorized official.

NPPES Registry Identity

NPI1164886040
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NamePEACH TREE HEALTHCARE
Location Address3810 ROSIN CT, SUITE 100Sacramento, CA 95834-1656
Mailing Address1114 Yuba St Ste 220Marysville, CA 95901-4838 · (530) 749-3242 · Fax (530) 749-3248
Phone(530) 741-6245
Fax(530) 741-9274
Organization SubpartNo
Authorized OfficialGreg S StoneCeo · (530) 741-6245
Enumeration DateApril 7, 2016
Last NPPES UpdateMay 23, 20224 updates tracked since enumeration
NPPES CertifiedMay 23, 2022
✔ NPI 1164886040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in CA · 030000463
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
3810 ROSIN CT, Sacramento, CA 95834
Open in Google Maps ↗

Other Names 1

Other NamePeach Tree North Sacramento

Secondary Practice Location 1

Location 12200 5th AveOroville, CA 95965-5816 · Phone (530) 533-1975

Other Identifiers 1

Other751916CA · Ptan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 for Provider-Performed Microscopy Procedures (PPMP) 05D0616752

Peach Tree Sacramento · Sacramento, CA
Active · expires Nov 13, 2027
CLIA Number05D0616752
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorRichard Fury
Laboratory Phone(916) 779-7656
Laboratory LocationPeach Tree Sacramento3810 Rosin Court, Sacramento, CA 95834
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

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

TURNING POINT COMMUNITY PROGRAMS
Clinic/Center (Adult Mental Health)
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
HOUAWA XIONG
Rehabilitation Practitioner
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
MARIA WHITE AYALA
Community Health Worker
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4220
IESHA ARNOLD
Adult Companion
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
RUTH VANESSA SEGURA ALVARENGA
Case Manager/Care Coordinator
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
MAI LOR
Case Manager/Care Coordinator
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
TARA LEANNE REYNOLDS
Case Manager/Care Coordinator
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 567-4222
MRS. SAFIYA CATHERINE PINKSTON-OJELADE
Counselor
3810 ROSIN CT
SACRAMENTO, CA 95834
Sacramento County (916) 809-1011

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 Peach Tree Healthcare's NPI number?

The NPI number for Peach Tree Healthcare is 1164886040. It was assigned to this organization in the NPPES registry on April 7, 2016. The provider is also known as Peach Tree North Sacramento.

Where is Peach Tree Healthcare located?

Peach Tree Healthcare is located at 3810 Rosin Ct Suite 100, Sacramento, CA 95834. The listed phone number is (530) 741-6245.

What is Peach Tree Healthcare's specialty?

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

Does Peach Tree Healthcare hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0616752) is associated with this NPI, valid through November 13, 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 Peach Tree Healthcare was last updated on May 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.