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PROVIDENCE MEDICAL FOUNDATION
NPI 1427305960
Family Medicine in Mission Viejo, CA

Active since August 14, 2012CLIA Certified · 7 labs
26522 LA ALAMEDA, SUITE 120, MISSION VIEJO, CA 92691(949) 364-9631 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 1, 2025, May 5, 2021, Sep 11, 2017 (3 updates tracked since 2017).

About Providence Medical Foundation NPPES

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

PROVIDENCE MEDICAL FOUNDATION (NPI 1427305960), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as a family medicine in Mission Viejo, California and active in the NPI registry since August 2012. The organization holds 7 active CLIA laboratory certificates and lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1427305960
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address26522 LA ALAMEDA, SUITE 120Mission Viejo, CA 92691-6330
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800
Phone(949) 364-9631
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateAugust 14, 2012
Last NPPES UpdateDecember 1, 20253 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1427305960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
26522 LA ALAMEDA, Mission Viejo, CA 92691
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Other Names 2

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

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 7

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 Compliance 05D2029948

Providence Medical Foundation · Mission Viejo, CA
Active · expires Mar 25, 2028
CLIA Number05D2029948
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorTuyet A. Nguyen
Laboratory Phone(949) 542-8007
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy, Ste 435, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D2296289

Providence Medical Foundation · Mission Viejo, CA
Active · expires Dec 26, 2027
CLIA Number05D2296289
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorRaymond Kwa
Laboratory Phone(949) 365-2444
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Parkway Suite 290, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D0994423

Providence Medical Foundation · Mission Viejo, CA
Active · expires Nov 9, 2027
CLIA Number05D0994423
Laboratory TypePhysician Office
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorChad Wadell
Laboratory Phone(949) 364-6000
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy Suite 315, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 05D0707127

Providence Medical Foundation · Mission Viejo, CA
Active · expires Jan 22, 2027
CLIA Number05D0707127
Laboratory TypePhysician Office
Certificate Effective DateJanuary 23, 2025
Certificate Expiration DateJanuary 22, 2027
Laboratory DirectorMinch K. Fong MD
Laboratory Phone(949) 347-0600
Laboratory LocationProvidence Medical Foundation27799 Medical Center Rd, Ste 460, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D0928547

Providence Medical Foundation · Mission Viejo, CA
Active · expires Oct 16, 2026
CLIA Number05D0928547
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2024
Certificate Expiration DateOctober 16, 2026
Laboratory DirectorEdward J. Block
Laboratory Phone(949) 364-5090
Laboratory LocationProvidence Medical Foundation27871 Medical Center Road, Suite #200, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2155712

Providence Medical Foundation · Mission Viejo, CA
Active · expires Oct 2, 2026
CLIA Number05D2155712
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateOctober 3, 2024
Certificate Expiration DateOctober 2, 2026
Laboratory DirectorArthur H. Loussararian
Laboratory Phone(949) 347-3620
Laboratory LocationProvidence Medical Foundation26800 Crown Valley Pkwy Suite 115, Mission Viejo, CA 92691
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

SILVERSTONE HOSPICE CARE INC
Hospice Care, Community Based
26522 LA ALAMEDA, SUITE 200
MISSION VIEJO, CA 92691
Orange County (949) 446-9960
TIMOTHY LEE KLEIN-MOHR PTA
Physical Therapist
26522 LA ALAMEDA, SUITE 100
MISSION VIEJO, CA 92691
Orange County (949) 582-2555
SHARON HOIER NP
Clinical Nurse Specialist (Acute Care)
26522 LA ALAMEDA
MISSION VIEJO, CA 92691
Orange County (949) 282-1618

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 1427305960. It was assigned to this organization in the NPPES registry on August 14, 2012. 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 26522 La Alameda Suite 120, Mission Viejo, CA 92691. The listed phone number is (949) 364-9631.

What is Providence Medical Foundation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Providence Medical Foundation hold CLIA laboratory certificates?

Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on December 1, 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.