ST JOSEPH HERITAGE HEALTHCARE - NPI 1780980169 - Family Medicine in Petaluma, CA

Q: What is St Jude Hospital Yorba Linda's NPI number?

The NPI number for St Jude Hospital Yorba Linda is 1780980169. It was assigned to this organization in the NPPES registry on February 2, 2011. The provider is doing business as St Joseph Heritage Healthcare.

Q: What is St Jude Hospital Yorba Linda's specialty?

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

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About St Joseph Heritage Healthcare NPPES

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

ST JOSEPH HERITAGE HEALTHCARE (NPI 1780980169) is a healthcare organization registered as a family medicine in Petaluma, California and active in the NPI registry since February 2011. The organization lists John Bennett, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1780980169

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameST JUDE HOSPITAL YORBA LINDA

Location Address24 W EL ROSE DRPetaluma, CA 94952-4023

Mailing Address279 Imperial Hwy, Suite 730Fullerton, CA 92835-1041 · (714) 449-4841 · Fax (714) 449-4956

Phone(707) 763-9891

Fax(707) 762-2311

Organization SubpartNo

Authorized OfficialJohn BennettChief Operating Officer · (714) 449-4800

Enumeration DateFebruary 2, 2011

✔ NPI 1780980169 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 ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

24 W EL ROSE DR, Petaluma, CA 94952

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Other Names 1

Doing Business AsSt Joseph Heritage Healthcare

Other Identifiers 1

Medicare PINBH969CA

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) 05D0604964

St Joseph Heritage Healthcare Annadel Medical Group · Petaluma, CA

Expired · Jul 19, 2026

CLIA Number05D0604964

Laboratory TypePhysician Office

Certificate Effective DateJuly 20, 2024

Certificate Expiration DateJuly 19, 2026

Laboratory DirectorMarion Guyer

Laboratory Phone(707) 763-9891

Laboratory LocationSt Joseph Heritage Healthcare Annadel Medical Group905 E Washington St, Petaluma, CA 94952

CLIA data matches this NPI record on: Name Phone

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.

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 St Jude Hospital Yorba Linda's NPI number?

The NPI number for St Jude Hospital Yorba Linda is 1780980169. It was assigned to this organization in the NPPES registry on February 2, 2011. The provider is doing business as St Joseph Heritage Healthcare.

Where is St Jude Hospital Yorba Linda located?

St Jude Hospital Yorba Linda is located at 24 W El Rose Dr, Petaluma, CA 94952. The listed phone number is (707) 763-9891.

What is St Jude Hospital Yorba Linda'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 St Jude Hospital Yorba Linda was last updated on February 2, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.