Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Medical Foundation

Organization Family Medicine Physician · NPI 1265015978

Providence Medical Foundation is a Family Medicine Physician in Santa Rosa, California. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

185 Sotoyome St
Santa Rosa, CA 95405-4803
Phone: (707) 303-8355
Fax: (707) 303-2035
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1265015978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group Northern California
NPI enumeratedApril 30, 2021
Last updated in NPPESJanuary 6, 2026
Certification dateJanuary 6, 2026
Mailing addressPo Box 31001 - 1920, Pasadena, CA 91110-1920

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