Organization
PETALUMA HEALTH CENTER INC
Active
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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