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PROVIDENCE MEDICAL FOUNDATION
NPI 1639715709
Family Medicine in Anaheim, CA

Active since November 22, 2019
200 W CENTER STREET PROMENADE, ANAHEIM, CA 92805(147) 123-5007 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 6, 2026, May 5, 2021, Nov 22, 2019 (3 updates tracked since 2019).

About Providence Medical Foundation NPPES

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

PROVIDENCE MEDICAL FOUNDATION (NPI 1639715709), doing business as St Joseph Heritage Healthcare, is a healthcare organization registered as a family medicine in Anaheim, California and active in the NPI registry since November 2019. The organization lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1639715709
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePROVIDENCE MEDICAL FOUNDATION
Location Address200 W CENTER STREET PROMENADEAnaheim, CA 92805-3960
Mailing AddressPo Box 31001 - 1920Pasadena, CA 91110-1920 · (714) 449-4800
Phone(147) 123-5007
Organization SubpartNo
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateNovember 22, 2019
Last NPPES UpdateJanuary 6, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2026
✔ NPI 1639715709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

200 W CENTER STREET PROMENADE, Anaheim, CA 92805
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Other Names 1

Former Legal Business NameSt Joseph Heritage Healthcare

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

Other Providers at the Same Location NPPES 10

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

AMY SANTOS
Health Educator
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (323) 774-3907
ST. JOSEPH HEALTH PERSONAL CARE SERVICES
In Home Supportive Care
200 W CENTER STREET PROMENADE, SUITE 200
ANAHEIM, CA 92805
Orange County (714) 712-7100
ST. JOSEPH HEALTH PERSONAL CARE SERVICES, LLC
Home Health
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (714) 449-4942
KATHERINE BAO LAM
Pharmacist (Ambulatory Care)
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (714) 618-9582
ST. JUDE HOSPITAL YORBA LINDA
Non-Pharmacy Dispensing Site
200 W CENTER STREET PROMENADE, SUITE 100B
ANAHEIM, CA 92805
Orange County (714) 347-7910
MIRAL A. KUMBHANI PHARMD
Pharmacist
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (555) 555-5555
BRYAN ORTIZ
Community Health Worker
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (657) 640-8090
ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES
Home Health
200 W CENTER STREET PROMENADE
ANAHEIM, CA 92805
Orange County (714) 449-4942

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 1639715709. It was assigned to this organization in the NPPES registry on November 22, 2019. The provider was formerly known as St Joseph Heritage Healthcare.

Where is Providence Medical Foundation located?

Providence Medical Foundation is located at 200 W Center Street Promenade, Anaheim, CA 92805. The listed phone number is (147) 123-5007.

What is Providence Medical Foundation's specialty?

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

When was this NPI record last updated?

The NPPES record for Providence Medical Foundation was last updated on January 6, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.