Organization
GRASSROOTS HEALTH A SOCIAL PURPOSE CORPORATION
Active
Other names
Grassroots DPC
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY MICHAEL CLINE MD (PHYSICIAN)
(707) 887-3651
Entity
Organization
Contact information
Practice address
97 DOBBINS ST STE A, VACAVILLE, CA 95688-2700
(707) 887-3651
(707) 210-0480
Mailing address
97 DOBBINS ST STE A, VACAVILLE, CA 95688-2700
(707) 887-3651
(707) 210-0480
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM1000X
Migrant Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
06/20/2025
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