Provider Demographics
NPI:1629960174
Name:SANTA ROSA COMMUNITY HEALT CENTERS
Entity type:Organization
Organization Name:SANTA ROSA COMMUNITY HEALT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEROI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-303-3600
Mailing Address - Street 1:120 STONY POINT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-4119
Mailing Address - Country:US
Mailing Address - Phone:707-303-3600
Mailing Address - Fax:
Practice Address - Street 1:925 CORPORATE CNTR PKWY STE A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5453
Practice Address - Country:US
Practice Address - Phone:707-303-3600
Practice Address - Fax:707-303-3636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)