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PROVIDENCE MEDICAL FOUNDATION
NPI 1386937225
Orthopaedic Surgery in Eureka, CA

Active since May 25, 2011CLIA 05D2155228 · Microscopy
2826 HARRIS ST, EUREKA, CA 95503(707) 443-8066(707) 268-3251 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 3, 2025, Jun 15, 2021, Dec 5, 2018 (3 updates tracked since 2018).

About Providence Medical Foundation NPPES

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

PROVIDENCE MEDICAL FOUNDATION (NPI 1386937225), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as an orthopaedic surgery in Eureka, California and active in the NPI registry since May 2011. The organization holds a CLIA Microscopy certificate valid through September 24, 2026 and lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1386937225
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address2826 HARRIS STEureka, CA 95503-4809
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920
Phone(707) 443-8066
Fax(707) 268-3251
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateMay 25, 2011
Last NPPES UpdateDecember 3, 20253 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
✔ NPI 1386937225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
2826 HARRIS ST, Eureka, CA 95503
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Other Names 2

Former Legal Business NameSt Joseph Heritage Healthcare
Former Legal Business NameSt Jude Hospital Yorba Linda

Other Identifiers 1

Other6852510001CA · Nsc

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) 05D2155228

Providence Medical Foundation · Eureka, CA
Active · expires Sep 24, 2026
CLIA Number05D2155228
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2024
Certificate Expiration DateSeptember 24, 2026
Laboratory DirectorDeepak Stokes
Laboratory Phone(707) 445-3443
Laboratory LocationProvidence Medical Foundation3200 Walford Ave, Eureka, CA 95503
CLIA data matches this NPI record on: Name
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 15

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

NATHAN M SHISHIDO M.D.
Orthopaedic Surgery
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066
EDWARD R EMMONS M.D.
Orthopaedic Surgery
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066
RAYMOND A KOCH M.D.
Orthopaedic Surgery
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8033
PAUL RUSSELL GUSTAVSON PA-C
Physician Assistant
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066
DANIEL S FARNUM M.D.
Orthopaedic Surgery
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 444-3118
LANCE RIVAS PA
Physician Assistant
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066
JOHN CHRISTOPHER KURYLO MD
Orthopaedic Surgery
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066
HUMBOLDT ORTHOPAEDIC MEDICAL ASSOCIATES, INC.
Durable Medical Equipment & Medical Supplies
2826 HARRIS ST
EUREKA, CA 95503
Humboldt County (707) 443-8066

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 Providence Medical Foundation's NPI number?

The NPI number for Providence Medical Foundation is 1386937225. It was assigned to this organization in the NPPES registry on May 25, 2011. The provider was formerly known as St Joseph Heritage Healthcare and St Jude Hospital Yorba Linda.

Where is Providence Medical Foundation located?

Providence Medical Foundation is located at 2826 Harris St, Eureka, CA 95503. The listed phone number is (707) 443-8066.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does Providence Medical Foundation hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D2155228) is associated with this NPI, valid through September 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.