Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
Kaiser Foundation Hospital Santa Rosa
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH L COFFEY (SENIOR VICE PRESIDENT, AREA MANAGER)
(707) 571-4222
Entity
Organization
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 393-4000
Mailing address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 393-4000
(707) 393-4556
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
110000213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050690B000000
DHS-SECTION 1011
CA
01
—
339040913
USDOL
CA
01
—
50690
BLUE CROSS OF CA
CA
05
—
HSP30690F
—
CA
05
—
HSP40690F
—
CA
01
—
ZZZA4902Z
BLUE SHIELD OF CA
CA
Enumeration date
11/07/2006
Last updated
04/20/2021
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