Organization
PETALUMA HEALTH CENTER INC
Active
Other names
Petaluma Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN POWELL (CEO)
(707) 559-7500
Entity
Organization
Contact information
Practice address
1179 N MCDOWELL BLVD, PETALUMA, CA 94954-6559
(707) 559-7500
(707) 559-7620
Mailing address
1179 N MCDOWELL BLVD, PETALUMA, CA 94954-6559
(707) 559-7597
(707) 658-1319
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
551879
MEDICARE NGS
CA
05
—
BCP70696F
—
CA
05
—
EAP70696F
—
CA
05
—
FHC70696F
—
CA
05
—
HAP70696F
—
CA
Enumeration date
08/18/2005
Last updated
05/07/2026
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