Organization
SANTA ROSA COMMUNITY HEALTH CENTERS
Active
Other names
Elsie Allen Campus, Southwest Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA BERNAL-LEROI CEO (CHIEF EXECUTIVE OFFICER)
(707) 303-3600
Entity
Organization
Contact information
Practice address
599 BELLEVUE AVE, SANTA ROSA, CA 95407-7713
(707) 528-5770
(707) 528-5770
Mailing address
3569 ROUND BARN CIRCLE, SANTA ROSA, CA 95403-5781
(707) 303-3600
(707) 303-3635
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000489
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70937F
—
CA
Enumeration date
12/05/2006
Last updated
12/09/2022
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