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Medi-Cal Provider DirectoryHumboldt County
CONTACT US
(800) 863-4155 | httpwwwpartnershiphporg
Revised Date May 4 2018
08-85215_CPL_001 04182013
Page i of i
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
TABLE OF CONTENTS
How to use this list 1Para usar esta lista 2Glossary of Terms 3Glosario de teacuterminos 5Nondiscrimination Notice 7Aviso de no discriminacioacuten 9Grievances 8Quejas 10Language Assistance 11Asistencia de idiomas 11Accessibility Standards 14Estaacutendares de Accesibilidad 15Timely Access to Care 16Acceso oportuno a la atencioacuten meacutedica 17Physician Listing Information 18Informacioacuten del listado de meacutedicos 18Humboldt Primary Care Provider 19
Arcata 19Eureka 22Ferndale 25Fortuna 26Garberville 28Hoopa 29McKinleyville 29Orleans 30Redway 30Scotia 31Weitchpec 31Willow Creek 32
Humboldt Facilities Pharmacy Urgent Care amp VSP List 33Hospitals Primary 33Hospitals Referral 33Mental Health Services - Outpatient 35Pharmacy Network List 35Skilled Nursing Long Term Care Facilities 38Vision Service Plan (VSP) (1-800-877-7195) 38
INDEX 40
Page 1 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
How to use this list
1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available
2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable
3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope
4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services
5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory
7 The telephone number listed under each site in this directory is the same number to call after normal businesshours
If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist
For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary
If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Page 2 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Para usar esta lista
1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible
2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible
3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos
4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios
5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)
6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores
7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio
Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)
Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista
Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario
Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)
Page 3 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC Provider Directory - Glossary of Terms
Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to
find an answer to your question please call Member Services at
(800) 863-4155
Accreditation
When a hospital goes through a review to assess the quality of its systems and processes by an outside organization
Ancillary Provider
An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc
Board Certification
Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area
Community Health Clinic
This is a clinic staffed by a group of doctors and nurses located in a community
Medical Group Affiliations
The practice or medical group the provider belongs to
Assigned Hospital
The hospital that your provider will send you to when you need care unless the care is not available at this hospital
Provider Languages
Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information
Provider Address
The location where services and care are rendered
Provider Site Status
Accepting New Patients The provider site is able to see new patients
Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site
Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page i of i
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
TABLE OF CONTENTS
How to use this list 1Para usar esta lista 2Glossary of Terms 3Glosario de teacuterminos 5Nondiscrimination Notice 7Aviso de no discriminacioacuten 9Grievances 8Quejas 10Language Assistance 11Asistencia de idiomas 11Accessibility Standards 14Estaacutendares de Accesibilidad 15Timely Access to Care 16Acceso oportuno a la atencioacuten meacutedica 17Physician Listing Information 18Informacioacuten del listado de meacutedicos 18Humboldt Primary Care Provider 19
Arcata 19Eureka 22Ferndale 25Fortuna 26Garberville 28Hoopa 29McKinleyville 29Orleans 30Redway 30Scotia 31Weitchpec 31Willow Creek 32
Humboldt Facilities Pharmacy Urgent Care amp VSP List 33Hospitals Primary 33Hospitals Referral 33Mental Health Services - Outpatient 35Pharmacy Network List 35Skilled Nursing Long Term Care Facilities 38Vision Service Plan (VSP) (1-800-877-7195) 38
INDEX 40
Page 1 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
How to use this list
1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available
2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable
3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope
4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services
5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory
7 The telephone number listed under each site in this directory is the same number to call after normal businesshours
If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist
For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary
If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Page 2 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Para usar esta lista
1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible
2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible
3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos
4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios
5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)
6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores
7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio
Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)
Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista
Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario
Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)
Page 3 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC Provider Directory - Glossary of Terms
Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to
find an answer to your question please call Member Services at
(800) 863-4155
Accreditation
When a hospital goes through a review to assess the quality of its systems and processes by an outside organization
Ancillary Provider
An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc
Board Certification
Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area
Community Health Clinic
This is a clinic staffed by a group of doctors and nurses located in a community
Medical Group Affiliations
The practice or medical group the provider belongs to
Assigned Hospital
The hospital that your provider will send you to when you need care unless the care is not available at this hospital
Provider Languages
Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information
Provider Address
The location where services and care are rendered
Provider Site Status
Accepting New Patients The provider site is able to see new patients
Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site
Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 1 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
How to use this list
1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available
2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable
3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope
4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services
5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory
7 The telephone number listed under each site in this directory is the same number to call after normal businesshours
If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist
For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary
If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711
Page 2 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Para usar esta lista
1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible
2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible
3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos
4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios
5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)
6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores
7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio
Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)
Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista
Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario
Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)
Page 3 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC Provider Directory - Glossary of Terms
Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to
find an answer to your question please call Member Services at
(800) 863-4155
Accreditation
When a hospital goes through a review to assess the quality of its systems and processes by an outside organization
Ancillary Provider
An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc
Board Certification
Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area
Community Health Clinic
This is a clinic staffed by a group of doctors and nurses located in a community
Medical Group Affiliations
The practice or medical group the provider belongs to
Assigned Hospital
The hospital that your provider will send you to when you need care unless the care is not available at this hospital
Provider Languages
Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information
Provider Address
The location where services and care are rendered
Provider Site Status
Accepting New Patients The provider site is able to see new patients
Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site
Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 2 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Para usar esta lista
1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible
2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible
3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos
4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios
5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)
6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores
7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio
Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)
Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista
Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario
Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)
Page 3 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC Provider Directory - Glossary of Terms
Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to
find an answer to your question please call Member Services at
(800) 863-4155
Accreditation
When a hospital goes through a review to assess the quality of its systems and processes by an outside organization
Ancillary Provider
An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc
Board Certification
Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area
Community Health Clinic
This is a clinic staffed by a group of doctors and nurses located in a community
Medical Group Affiliations
The practice or medical group the provider belongs to
Assigned Hospital
The hospital that your provider will send you to when you need care unless the care is not available at this hospital
Provider Languages
Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information
Provider Address
The location where services and care are rendered
Provider Site Status
Accepting New Patients The provider site is able to see new patients
Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site
Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 3 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC Provider Directory - Glossary of Terms
Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to
find an answer to your question please call Member Services at
(800) 863-4155
Accreditation
When a hospital goes through a review to assess the quality of its systems and processes by an outside organization
Ancillary Provider
An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc
Board Certification
Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area
Community Health Clinic
This is a clinic staffed by a group of doctors and nurses located in a community
Medical Group Affiliations
The practice or medical group the provider belongs to
Assigned Hospital
The hospital that your provider will send you to when you need care unless the care is not available at this hospital
Provider Languages
Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information
Provider Address
The location where services and care are rendered
Provider Site Status
Accepting New Patients The provider site is able to see new patients
Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site
Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 4 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility
Not Accepting New Patients The provider site is not able to add new patients to their site
Specialty Type
Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital
Wheelchair amp Accessibility Codes
This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms
Levels of Access
Accessibility Codes (see page 13 for a description of codesP EB IB R E T )
Basic Access
The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)
Limited Access
The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T
Medical Equipment Access
The office meets the standard below for exam tables and scales (T)
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 5 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Directorio de proveedores de PHC - Glosario de teacuterminos
Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de
PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al
(800) 863-4155
Acreditacioacuten
Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa
Proveedores auxiliares
Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc
Certificacioacuten de la Junta
Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea
Cliacutenica de salud de la comunidad
Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad
Afiliaciones de grupo meacutedico
El consultorio o grupo meacutedico al que pertenece el proveedor
Hospital Asignado
El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital
Idiomas del proveedor
Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor
Direccioacuten del proveedor
El lugar donde se prestan los servicios y la atencioacuten
Estado del sitio del proveedor
Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos
Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio
Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 6 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
pacientes que son referidos por su meacutedico de atencioacuten primaria
Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro
No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio
Tipo de especialidad
Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital
Sillas de ruedas y coacutedigos de accesibilidad
Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos
Niveles de acceso
Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )
Acceso baacutesico
El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)
Acceso limitado
El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T
Acceso de equipo meacutedico
El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 7 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
NONDISCRIMINATION NOTICE
Discrimination is against the law Partnership HealthPlan of California follows
Federal civil rights laws Partnership HealthPlan of California does not
discriminate exclude people or treat them differently because of race color
national origin age disability or sex
Partnership HealthPlan of California provides
Free aids and services to people with disabilities to help them communicate
better such as
Qualified sign language interpreters
Written information in other formats (large print audio accessible
electronic formats other formats)
Free language services to people whose primary language is not English
such as
Qualified interpreters
Information written in other languages
If you need these services contact Partnership HealthPlan of California between
8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well
please call (800) 735-2929 or 711
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 8 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
HOW TO FILE A GRIEVANCE
If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another
way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan
of California You can file a grievance by phone in writing in person or electronically
bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or
if you cannot hear or speak well please call (800) 735-2929 or 711
bull In writing Fill out a complaint form or write a letter and send it to
Partnership HealthPlan of California
4665 Business Center Drive
Fairfield CA 94534
OR
Partnership HealthPlan of California
3688 Avtech Parkway
Redding CA 96002
bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance
bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg
OFFICE OF CIVIL RIGHTS
You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights
by phone in writing or electronically
bull By phone Call (800) 368-1019 If you cannot speak or hear well please call
TTYTDD (800) 537-7697
bull In writing Fill out a complaint form or send a letter to
US Department of Health and Human Services
200 Independence Avenue SW
Room 509F HHH Building
Washington DC 20201
Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml
bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 9 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
AVISO DE NO DISCRIMINACIOacuteN
La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo
Partnership HealthPlan of California proporciona
Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como
Inteacuterpretes de lenguaje de sentildeas calificados
Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)
Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como
Inteacuterpretes calificados
Informacioacuten escrita en otros idiomas
Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 10 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
COMO PRESENTAR UNA QUEJA
Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711
Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a
Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534
O
Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002
En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja
Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg
OFICINA DE DERECHOS CIVILES
Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica
Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697
Por escrito Llene un formulario de reclamo o enviacutee una carta a
US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201
Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml
Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 11 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
LANGUAGE ASSISTANCE English
ATTENTION If you speak another language language assistance services free of
charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)
Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de
asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны
бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or
711)
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh
cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY
(800) 735-2929 or 711)
한국어 (Korean)
주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실
수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해
주십시오
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 12 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
繁體中文(Chinese)
注意如果您使用繁體中文您可以免費獲得語言援助服務請致電
(800) 863-4155 (TTY (800) 735-2929 or 711)
Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար
կարող են տրամադրվել լեզվական աջակցության ծառայություններ
Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)
(Farsi) فارسی
اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه
تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با
日本語 (Japanese)
注意事項日本語を話される場合無料の言語支援をご利用いただ
けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご
連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj
kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)
ਪਜਾਬੀ (Punjabi)
ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ
ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 13 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
(Arabic) العربية
تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت
711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم
or (800) 735-2929)
ह दी (Hindi)
धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए
उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร
โทร (800) 863-4155 (TTY (800) 735-2929 or 711)
មែរ (Cambodian)
រយន ររ ើសននកនយ មែ រសជនយមននក
រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155
(TTY (800) 735-2929 or 711)
ພາສາລາວ (Laotian)
ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ
ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)
735-2929 or 711)
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 14 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Accessibility Standards for Seniors and Persons with Disabilities
This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need
Levels of Access
Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)
Medical Equipment Access The office meets the standard below for exam tables and scales (T)
Accessibility Codes
= Wheelchair Accessible
P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas
EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use
IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help
R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use
E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around
T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 15 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades
Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita
Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)
Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)
Coacutedigos de accesibilidad
= Accesible a silla de ruedas (Wheelchair Accessible)
P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas
EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar
IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda
R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar
E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta
T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 16 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Timely Access to Care
This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711
Appointment Type Must Get Appointment Within
Urgent care appointments that do not require pre-approval (prior authorization)
48 hours
Urgent care appointment that do require prior authorization
96 hours
Non-urgent primary care appointments 10 business days
Non-urgent specialist 15 business days
Non-urgent mental health provider (non-physician)
10 business days
Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition
15 business days
Telephone wait times during normal business hours
10 minutes
Triage ndash 247 services 247 services ndash No more than 30 minutes
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 17 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Acceso oportuno a la atencioacuten meacutedica
Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711
Tipo de cita Debe obtener la cita dentro de
Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)
48 horas
Cita de atencioacuten de urgencia que requieren autorizacioacuten previa
96 horas
Citas de atencioacuten meacutedica primaria no urgentes
10 diacuteas laborales
Especialista no urgente 15 diacuteas laborales
Proveedor de salud mental no urgente (profesional de la salud no meacutedico)
10 diacuteas laborales
Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud
15 diacuteas laborales
Tiempos de espera al teleacutefono durante el horario normal de trabajo
10 minutos
Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 18 of 41
PHC PROVIDERS | HUMBOLDT COUNTY DIRECTORY
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
Physician Listing Information
To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155
How to read the Provider Directory To help you in your selection the following information is provided about each personal physician
Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor
City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad
Provider Site Name Family Medical Center Nombre del Sitio del Proveedor
PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP
Enrollment Status Open to New Patients Estado de Inscribirse
Ages Accepted Ages No Age Limitations Las Edades Aceptadas
Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital
Address 1234 Hospital Drive
Fairfield CA 94534
Direccioacuten
Accessibility P EB IB R E T Accesibilidad
Phone (707) 555-5555 (phn) Teleacutefono
Fax (707) 555-5556 (fax) Fax
URL Website wwwabc123com URL Sitio Web
Hours Mon ndash Fri 8 am ndash 6 pm Horas
Medical Specialty Family Practice Especialidad Meacutedica
Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico
NPI 1234567890 NPI
License Number A12345 Nuacutemero de Licencia
Languages Spanish Tagalog Idiomas
Special Accommodations and Levels of Access
Adj Exam Tables
Special Scales for Wheelchairs
Scales that weigh up to 300lbs
Hoyer Lift
Gurney Accommodations
Hearing Impaired Accommodations
Onsite Interpretation Services
Basic Access
Alojamiento Especial y
Niveles de Acceso
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 19 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Arcata
Full Circle Center for Integrative Medicine ^1^
PCP PHC 32508-0004
NPI 1790853083Family MedicineAccepting Existing Patients
19 Years and Older
4641 Valley East Blvd Ste 2Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 840-4701Primary Fax (855) 420-6321wwwfullcirclemedorgMon Tue 830 AM - 300 PMWed - Fri 830 AM - 500 PMSat By Appointment Only
Family MedicineBasch Corinne Vivian MD ^2^
diams Family MedicineNPI 1790853083License A51185Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 480lbs
Humboldt Open Door Clinic ^3^
Open Door Community Health CentersPCP PHC 2520-0007
NPI 1255435533FQHCFamily Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
770 10th StArcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 826-8610Primary Fax (707) 826-8623wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineNorvell Cindy J MD ^4^
diams Family MedicineNPI 1093733669License A64170Gender FemaleScher Sarah Anne MD ^5^
diams Family MedicineNPI 1437246295License G70889Gender FemaleWeiss Ellen A MD ^6^
diams Family MedicineNPI 1821184979License G74528Gender FemaleZwerling Alden P MD ^7^
diams Family MedicineNPI 1316987852License G48415Gender Male
PediatricsBell Norman Joseph MD ^8^
NPI 1194819888License G16386Gender MaleRobertson Anna DO ^9^
diams PediatricsNPI 1629402466License 20A13679Gender FemaleRussian Spanish
Hatch Deborah Ann NP ^10^
NPI 1366528390License 3057Gender FemaleHorwitz David J PA ^11^
NPI 1386739845License PA10646Gender MaleHoyt Lisa M NP ^12^
NPI 1811081524License 10169Gender FemaleMaynor Audrey C PA-C ^13^
NPI 1609301241License 54374Gender FemaleSpanishMoss Tara S PA ^14^
NPI 1679660187License PA17518Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 20 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^15^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCPediatricsAccepting Existing Patients
0-18 YearsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 825-4938Primary Fax (707) 826-8255Mon - Fri 200 PM - 700 PM
PediatricsPoterack Catherine D MD ^16^
diams PediatricsNPI 1811102171License G89300Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^17^
Mad River CommunityPCP PHC 41338-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3798 Janes Rd Ste 10Arcata CA 95521 PEBIBRE
Level of Access BasicPrimary Phone (707) 822-7041Primary Fax (707) 822-0655Mon - Thu 800 AM - 400 PMFri 800 AM - 200 PM
Family MedicinePalacios Alison M DO ^18^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Scales that weigh up to 450lbs
Mad River Healthcare Clinic ^19^
Mad River CommunityPCP PHC 28014-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 14Arcata CA 95521 PEBIBE
Level of Access LimitedPrimary Phone (707) 822-0293Primary Fax (707) 822-0294Mon - Thu 900 AM - 400 PMFri 900 AM - 1200 PM
Hall Laura E FNP ^20^
NPI 1255781340License 95003431Gender FemaleWizes Veronica Renee NP ^21^
NPI 1942298955License 13263Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 21 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Mad River Healthcare Clinic ^22^
Mad River CommunityPCP PHC 35863-0001
NPI 1609979707RHCFamily MedicineAccepting Existing Patients
19 Years and Older
3798 Janes Rd Ste 3Arcata CA 95521 PIBE
Level of Access LimitedPrimary Phone (707) 825-4939Primary Fax (707) 825-4935Mon - Fri 900 AM - 430 PM
Bosserman Mariel A ANP ^23^
NPI 1548610934License 95003971Gender FemaleFowler Vickie L NP ^24^
NPI 1952625881License 22550Gender FemaleMcCurtain Loretta R NP ^25^
NPI 1235338096License 8557Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
North Country Clinic ^26^
Open Door Community Health CentersPCP PHC 28025-0001
NPI 1689778813FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
785 18th StArcata CA 95521 IBE
Level of Access LimitedPrimary Phone (707) 822-2481Primary Fax (707) 822-3656wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineAlston Gerald Anthony MD ^27^
diams Family MedicineNPI 1578650388License G84779Gender MaleSpanishHospital Privileges Mad River Community HospitalBurns Judy A MD ^28^
diams Family MedicineNPI 1679669253License G59037Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Denton Heidi M DO ^29^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHoopman Eloi J DO ^30^
diams Family MedicineNPI 1629204557License 20A11232Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^31^
NPI 1710390711License 20A14333Gender FemaleOhnemus Julie Marie MD ^32^
diams Family MedicineNPI 1770676306License G66596Gender FemaleSpanishHospital Privileges Mad River Community HospitalVu Kelvin K DO ^33^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Lam Dung Gloria T NP ^34^
NPI 1972052496License 95005031Gender FemaleLowry Caroline A PA-C ^35^
NPI 1245432996License PA51595Gender Female
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 22 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Sweitzer Deborah S PA ^36^
NPI 1346335700License PA50919Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Potawot Health Village ^37^
United Indian Health Services IncPCP PHC 27336-0010
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
1600 Weeot WayArcata CA 95521 PIBRE
Level of Access LimitedSkilled Medical Interpreter ServicePrimary Phone (707) 825-5000Primary Fax (707) 825-6736wwwunitedindianhealthservicesorgMon - Fri 800 AM - 500 PM
Family MedicineCassel Kathleen M MD ^38^
diams Family MedicineNPI 1962400051License A70180Gender FemaleHospital Privileges Mad River Community Hospital
Kent Hugh D MD ^39^
diams Family MedicineNPI 1467740662License A134487Gender MaleMartinez Antoinette Patricia MD ^40^
diams Family MedicineNPI 1891855052License A88873Gender FemaleHospital Privileges Mad River Community HospitalRaymer Terry W MD ^41^
diams Family MedicineNPI 1902804099License G61883Gender Male
McAtasney Grace Elaine NP ^42^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^43^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Eureka
Eureka Community Health Center ^44^
Open Door Community Health CentersPCP PHC 3946-0008
NPI 1669569109FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients
No Age LimitationsCHDP Provider
2200 Tydd StEureka CA 95501 PEBE
Level of Access LimitedPrimary Phone (707) 441-1624Primary Fax (707) 441-1253wwwopendoorhealthcom
opendoorMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM
Family MedicineChristensen Anne E DO ^45^
diams Family MedicineNPI 1871632893License 20A12659Gender FemaleHunter Willard Merrell MD ^46^
diams Family MedicineNPI 1477589323License G30611Gender MaleKummerling Marissa L MD ^47^
diams Family MedicineNPI 1467897942License A149373Gender Female
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 23 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineHonda Malia Ann Kiyomi MD ^48^
NPI 1689094989License A139453Gender Female
PediatricsEllis Mark G MD ^49^
diams PediatricsNPI 1003812744License G65432Gender MaleHospital Privileges St Joseph HospitalFittinghoff Leslie A MD ^50^
diams PediatricsNPI 1902844046License G72571Gender FemaleSteele Lauren E MD ^51^
NPI 1780028340License A132448Gender FemaleSpanish
Brubaker Andrea B FNP ^52^
NPI 1104342070License 95007296Gender FemaleDietz Suzanne Michaels NP ^53^
NPI 1033113535License 6504Gender FemaleGeller Marc B PA-C ^54^
NPI 1356798920License 53648Gender MaleHoyt Lisa M NP ^55^
NPI 1811081524License 10169Gender Female
Kelly Casey N PA ^56^
NPI 1205076015License PA20196Gender FemaleKrause Abigail B PA ^57^
NPI 1093190563License 52622Gender FemaleMetcalfe Kristen Zoe PA ^58^
NPI 1962690594License PA19392Gender FemaleMosher-Carbiener Charmaine Marie NP ^59^
NPI 1932433950License 10751Gender FemaleRice Ashley M FNP ^60^
NPI 1902322894License 95007874Gender FemaleStroup Allegra Beatrice FNP ^61^
NPI 1982018966License 95000855Gender FemaleTaylor Ellen E PA ^62^
NPI 1962598680License PA11331Gender FemaleFrench German Russian SpanishWest Christopher Eugene NP ^63^
NPI 1316293467License 22389Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Humboldt Medical Specialists ^64^
PCP PHC 46702-0001
NPI 1871607762Internal MedicineAccepting New Patients
19 Years and Older
3200 Walford AveEureka CA 95503 Primary Phone (707) 445-3443Primary Fax (707) 445-1848Mon - Fri 830 AM - 500 PM
Internal MedicineStokes Deepak Kumar MD ^65^
diams Obstetrics amp GynecologyNPI 1528066206License A33996Gender MaleHindiHospital Privileges St Joseph Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Humboldt Medical Specialists Inc
^66^
PCP PHC 28019-0004
NPI 1871607762Family Medicine Internal MedicineAccepting Existing Patients
19 Years and Older
2280 Harrison Ave Ste BEureka CA 95501 PIBE
Level of Access LimitedPrimary Phone (707) 443-9371Primary Fax (707) 443-2620Mon - Fri 830 AM - 430 PM
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 24 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineJohnson Libre E MD ^67^
diams Family MedicineNPI 1770683658License A76860Gender MaleHospital Privileges St Joseph Hospital
Internal MedicineAbels Gloria Beth MD ^68^
diams Internal MedicineNPI 1235236662License G64604Gender FemaleHospital Privileges St Joseph HospitalCataldo Stuart D MD ^69^
diams Internal MedicineNPI 1962507590License A70399Gender MaleHospital Privileges St Joseph HospitalKessler Bruce E MD ^70^
diams Internal MedicineNPI 1811093461License G31775Gender MaleHospital Privileges St Joseph HospitalKuhfahl Petra MD ^71^
diams Internal MedicineNPI 1184719684License G85976Gender FemaleFrench GermanSteinberg Miriam Dena DO ^72^
diams Family MedicineNPI 1518263227License 20A11519Gender Female
Wilke Allan J MD ^73^
diams Family Medicinediams Geriatric Medicine - Internal
MedicineNPI 1366404097License C151694Gender Male
Fisher Patricia L NP ^74^
NPI 1952552762License 20312Gender FemaleFlowers Amber D NP ^75^
NPI 1164897179License 95003500Gender FemaleHatchimonji Rachel L NP ^76^
NPI 1023480126License 95003027Gender FemaleJames Amanda B NP ^77^
NPI 1831295484License 9942Gender Female
Special Accommodations Adj Exam Tables Medical Equipment Access Scales that weigh up to 500lbs
Open Door Mobile Health Services ^78^
Open Door Community Health CentersPCP PHC 28028-0001
NPI 1336173020FQHCFamily Medicine Internal MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2426 Buhne StEureka CA 95501 EB
Level of Access LimitedPrimary Phone (707) 443-4666Primary Fax (707) 445-4499wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineDenton Heidi M DO ^79^
diams Family Medicinediams Neuromusculoskeletal Medicine amp
OMMNPI 1982086385License 20A14116Gender FemaleHovorka Gail Scott MD ^80^
diams Family MedicineNPI 1417043969License C52007Gender FemaleSpanishVu Kelvin K DO ^81^
diams Family MedicineNPI 1386806081License 20A11060Gender MaleVietnamese
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 25 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Internal MedicineMehta Rohan V MD ^82^
diams Internal Medicinediams NephrologyNPI 1255642427License A136902Gender MaleSpanish
Smith Kathy S FNP ^83^
NPI 1427147347License 95006478Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Redwood Community Health Center ^84^
Open Door Community Health CentersPCP PHC 34371-0001
NPI 1336173020FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
2350 Buhne St Ste AEureka CA 95501 PEBIBE
Level of Access LimitedPrimary Phone (707) 443-4593Primary Fax (707) 269-7116wwwopendoorhealthcom
opendoorMon Thu 800 AM - 500 PMTue Wed 800 AM - 1200 PMFri 800 AM - 300 PM
Family MedicineHong May C MD ^85^
diams Family MedicineNPI 1811933690License A93205Gender FemaleLadika Courtney C MD ^86^
diams Family MedicineNPI 1952539561License A116422Gender Female
Lake Kristen N FNP ^87^
NPI 1720527336License 95007613Gender FemaleRoyster Marilyn H FNP ^88^
NPI 1326566811License 95007800Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs
Ferndale
Ferndale Community Health Center ^89^
Open Door Community Health CentersPCP PHC 32560-0001
NPI 1598178915FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
638 Main StFerndale CA 95536 PEBIBET
Level of Access LimitedPrimary Phone (707) 786-4028Primary Fax (707) 786-9029wwwopendoorhealthcom
opendoorMon - Fri 800 AM - 500 PM
Family MedicineBaird Donald I MD ^90^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDennis Tamara Smith MD ^91^
diams Family MedicineNPI 1952396103License A92702Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 26 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hawk Heather J NP ^92^
NPI 1083159479License 95005626Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Medical Equipment Access Scales that weigh up to 500lbs
Fortuna
Fortuna Community Health Center ^93^
Open Door Community Health CentersPCP PHC 32561-0001
NPI 1306252051FQHCFamily MedicineAccepting New Patients
No Age Limitations
3304 Renner DrFortuna CA 95540 PE
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon - Thu 900 AM - 300 PM
Family MedicineBaird Donald I MD ^94^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Murray Angela N PA-C ^95^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Community Health Center ^96^
Open Door Community Health CentersPCP PHC 32563-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3306 Renner DrFortuna CA 95540 PEBIBRET
Level of Access BasicPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorMon Tue 800 AM - 500 PMFri 800 AM - 1200 PM
Family MedicineBaird Donald I MD ^97^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial Hospital
Estlin Katherine A MD ^98^
diams Family MedicineNPI 1255574885License A143957Gender FemaleMcAtee Joni L MD ^99^
diams Family MedicineNPI 1689971814License A150338Gender FemaleProudfoot Jacqueline J MD ^100^
diams Family MedicineNPI 1407261001License A141233Gender FemaleShegog Margarette J MD ^101^
diams Family MedicineNPI 1508202821License A150203Gender Female
Medina David M PA-C ^102^
NPI 1245342732License 17932Gender MaleMurray Angela N PA-C ^103^
NPI 1063746287License 20502Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 27 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Fortuna Community Health Center ^104^
Open Door Community Health CentersPCP PHC 32562-0001
NPI 1306252051FQHCFamily MedicineAccepting Existing Patients
No Age Limitations
3307 Renner DrFortuna CA 95540 PEBIB
Level of Access LimitedPrimary Phone (707) 725-6101Primary Fax (707) 725-2978wwwopendoorhealthcom
opendoorWed Thu 800 AM - 500 PMFri 1200 PM - 100 PM
Family MedicineBaird Donald I MD ^105^
NPI 1972554301License G32307Gender MaleHospital Privileges Redwood Memorial HospitalDittmer Stephanie Suzanne MD ^106^
NPI 1942422688License A117789Gender FemaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Family Medical Group ^107^
PCP PHC 19669-0005
NPI 1376655217RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
874 Main StFortuna CA 95540 EBIBR
Level of Access LimitedPrimary Phone (707) 725-3334Primary Fax (707) 725-2455Mon - Fri 800 AM - 530 PM
Family MedicineBrinckhaus Ruben E MD ^108^
NPI 1891708806License G61840Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Downie-Allman Fannette R NP ^109^
NPI 1952597163License 7753Gender FemaleHeiob Roxane K FNP ^110^
NPI 1164834578License 95000278Gender FemaleReese Barbara F NP ^111^
NPI 1760546626License 6996Gender FemaleSpanishWerner Whitney M PA ^112^
NPI 1629011754License PA52150Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Fortuna Health Clinic ^113^
United Indian Health Services IncPCP PHC 27933-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner Dr Ste CFortuna CA 95540 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (707) 725-7988Primary Fax (707) 725-8088wwwunitedindianhealthservicesorgMon Tue Thu Fri 800 AM - 430 PM
McAtasney Grace Elaine NP ^114^
NPI 1457804619License 02960Gender FemaleRousselot Anthony Max PA ^115^
NPI 1568460608License PA13540Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 350lbs
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 28 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Redwood Pediatric Medical Group
^116^
PCP PHC 27937-0001
NPI 1164574083RHCPediatricsAccepting Existing Patients
0-20 YearsCHDP Provider
3305 Renner DrFortuna CA 95540 PIB
Level of Access LimitedPrimary Phone (707) 725-9355Primary Fax (707) 725-2426Mon - Fri 830 AM - 500 PMSat 1000 AM - 1200 PM
PediatricsBuxbaum Evan R MD ^117^
NPI 1174633069License A116531Gender MaleHospital Privileges Redwood Memorial HospitalKillfoil James J MD ^118^
diams PediatricsNPI 1790881951License G82256Gender MaleSpanishHospital Privileges Redwood Memorial Hospital
Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs
St Joseph Health Rural Health Clinic ^119^
PCP PHC 46187-0001
NPI 1194189654RHCFamily MedicineAccepting Existing Patients
No Age LimitationsCHDP Provider
3302 Renner DrFortuna CA 95540 EBIB
Level of Access LimitedPrimary Phone (707) 725-3318Primary Fax (707) 725-1998Mon - Fri 830 AM - 500 PM
Family MedicineOlkin Philip L MD ^120^
NPI 1508897950License G32253Gender MaleHospital Privileges Redwood Memorial Hospital
Coleman John K PA-C ^121^
NPI 1174558845License 13661Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs
Garberville
Southern Humboldt Community Clinic ^122^
PCP PHC 28031-0001
NPI 1336367515RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
509 Elm StGarberville CA 95542 EBIB
Level of Access LimitedPrimary Phone (707) 923-3925Primary Fax (707) 923-3902Mon - Fri 830 AM - 500 PM
Family MedicineGadallah Yousri E MD ^123^
diams Family MedicineNPI 1841225927License C145710Gender MaleArabicRucker Mylene M MD ^124^
NPI 1801813555License A44598Gender FemaleHospital Privileges Jerold Phelps Community Hospital
Beach Sarah Darlene FNP ^125^
NPI 1356878615License 95006920Gender FemaleCandiotti Linda Helene PA-C ^126^
NPI 1316011893License 12137Gender Female
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
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Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 29 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Hayes Barbara Ann NP ^127^
NPI 1396876710License 10912Gender Female
Special Accommodations Adj Exam Tables Hoyer Lift Scales that weigh up to 350lbs
Hoopa
Kimaw Medical Center ^128^
PCP PHC 28020-0023
NPI 1306904222Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
535 Airport RdHoopa CA 95546 PEBIBRET
Level of Access BasicPrimary Phone (530) 625-4261Primary Fax (530) 625-5239wwwkimaworgMon Tue Thu Fri 830 AM - 500 PMWed 100 PM - 500 PM
Family MedicineChase Emmett MD ^129^
diams Undersea amp Hyperbaric Medicine - Preventive Medicine
NPI 1902976897License GFE51614Gender Male
Smith Eva M MD ^130^
diams Family Medicinediams Undersea amp Hyperbaric Medicine -
Preventive MedicineNPI 1982773099License C42592Gender Female
Langhurst Tracy L PA-C ^131^
NPI 1689826091License 53046Gender FemaleWalsh Susan N NP ^132^
NPI 1306915418License 11681Gender Female
Special Accommodations Medical Equipment Access
McKinleyville
Humboldt Family Medical Care ^133^
Mad River CommunityPCP PHC 28023-0001
NPI 1447287347RHCFamily MedicineAccepting Existing Patients
19 Years and Older
1733 Central AveMcKinleyville CA 95519 IBRE
Level of Access LimitedPrimary Phone (707) 839-4852Primary Fax (707) 839-2439Mon - Thu 830 AM - 430 PM
Family MedicineMahan Marcelle Owens MD ^134^
NPI 1245292085License G71860Gender FemaleHospital Privileges Mad River Community Hospital
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
McKinleyville Community Health Center ^135^
Open Door Community Health CentersPCP PHC 13183-0008
NPI 1598858169FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
1644 Central AveMcKinleyville CA 95519 EBIBE
Level of Access LimitedPrimary Phone (707) 839-3068Primary Fax (707) 839-3827Mon - Fri 800 AM - 500 PM
Family MedicineCarlson William Peter MD ^136^
diams Family MedicineNPI 1760426761License G32605Gender MaleHospital Privileges Mad River Community Hospital
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 30 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Copple Nathan R MD ^137^
diams Family MedicineNPI 1043307853License G74334Gender MaleHospital Privileges Mad River Community HospitalEbel Valerie J MD ^138^
diams Family MedicineNPI 1356784532License A132130Gender FemaleHospital Privileges Mad River Community HospitalMartini Jenna R DO ^139^
NPI 1710390711License 20A14333Gender FemaleVu Tara Arness MD ^140^
diams Family MedicineNPI 1588821847License A105944Gender FemaleSpanishHospital Privileges Mad River Community Hospital
Goodwin Nina Bleue NP ^141^
NPI 1306841259License 12710Gender FemaleFrench SpanishHall Sacha B PA-C ^142^
NPI 1093234882License 54808Gender FemaleLyons Laura L NP ^143^
NPI 1174693436License 10982Gender Female
Spellmeyer Elizabeth E FNP ^144^
NPI 1194126680License 95005116Gender Female
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 1000lbs
Orleans
Karuk Orleans Medical Clinic ^145^
PCP PHC 28021-0002
NPI 1386726032Family MedicineAccepting New Patients
No Age LimitationsCHDP Provider
325 Asip RdOrleans CA 95556 PEBIBRE
Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 627-3452Primary Fax (530) 627-3445Mon - Fri 800 AM - 500 PM
Family MedicineVasquez Tony Escalona MD ^146^
diams Nuclear MedicineNPI 1477524197License G52980Gender Male
Goodwin Gregory T PA ^147^
NPI 1427197920License 14029Gender Male
Special Accommodations Scales that weigh up to 500lbs
Redway
Redwoods Rural Health Center ^148^
PCP PHC 27948-0001
NPI 1235206087FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
101 West Coast RdRedway CA 95560 EBIBE
Level of Access LimitedPrimary Phone (707) 923-2783Primary Fax (707) 923-2543Mon - Fri 800 AM - 530 PM
Family MedicineScheel Philip Richard MD ^149^
diams Family MedicineNPI 1922053305License A78623Gender Male
Barnes Robin L FNP ^150^
NPI 1629529557License 95005313Gender FemaleBattles Mandi Lisette PA ^151^
NPI 1538398870License PA20367Gender FemaleHegdal Juliet Karen FNP ^152^
NPI 1790964336License 17324Gender Female
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
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Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 31 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Scotia
Scotia Bluffs Community Health Center ^153^
Southern Trinity Health ServicesPCP PHC 28032-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
500 B St Ste AScotia CA 95565 IBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgMon - Wed 900 AM - 600 PM
Family MedicineSchafle Michael F MD ^154^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^155^
NPI 1083902688License 20667Gender FemaleMeyers Mary A NP ^156^
NPI 1417129222License 17298Gender Female
Tinkelenberg James W PA ^157^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 500lbs
Scotia Bluffs Community Health Center ^158^
Southern Trinity Health ServicesPCP PHC 33371-0001
NPI 1174693493FQHCFamily MedicineAccepting New Patients
No Age Limitations
500 B St Ste BScotia CA 95565 EBIBE
Level of Access LimitedPrimary Phone (707) 764-5617Primary Fax (707) 764-5618wwwsthsclinicorgThu Fri 830 AM - 500 PMSat 800 AM - 100 PM
Family MedicineSchafle Michael F MD ^159^
NPI 1831262708License C42249Gender MaleHospital Privileges Trinity Hospital
Lee Sandra Y NP ^160^
NPI 1083902688License 20667Gender Female
Meyers Mary A NP ^161^
NPI 1417129222License 17298Gender FemaleTinkelenberg James W PA ^162^
NPI 1205978392License PA19044Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs
Weitchpec
Weitchpec Health Clinic ^163^
United Indian Health Services IncPCP PHC 28034-0001
NPI 1497751572Family MedicineAccepting Native American Indians
No Age LimitationsAccepting Existing Patients
No Age LimitationsCHDP Provider
11500 Hwy 96 Libby Nix Community CenterWeitchpec CA 95546 EBIBRE
Level of Access LimitedPrimary Phone (530) 625-4300Primary Fax (530) 625-4308wwwunitedindianhealthservicesorgMon Thu Fri 930 AM - 300 PM
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 32 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PRIMARY CARE PROVIDERS
HUMBOLDT COUNTY DIRECTORY
Family MedicineKent Hugh D MD ^164^
diams Family MedicineNPI 1467740662License A134487Gender MaleYoung-Tripp Sawar C MD ^165^
diams Family MedicineNPI 1093924052License MD150077Gender Male
Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 440lbs
Willow Creek
Six Rivers Medical Center ^166^
Mad River CommunityPCP PHC 28024-0002
NPI 1376570473RHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
850 State Highway 96Willow Creek CA 95573 IBRE
Level of Access LimitedPrimary Phone (530) 629-3116Primary Fax (530) 629-2866Mon Tue Thu Fri 830 AM - 500 PMWed 830 AM - 230 PM
Family MedicinePalacios Alison M DO ^167^
diams Family MedicineNPI 1265708424License 20A11631Gender FemaleHospital Privileges Mad River Community Hospital
Stollmeyer Kathryn M PA ^168^
NPI 1033315635License PA19225Gender Female
Special Accommodations Adj Exam Tables Scales that weigh up to 440lbs
Willow Creek Community Health Center ^169^
Open Door Community Health CentersPCP PHC 28027-0001
NPI 1730330739FQHCFamily MedicineAccepting New Patients
No Age LimitationsCHDP Provider
38883 Hwy 299Willow Creek CA 95573 PEBIBRE
Level of Access BasicPrimary Phone (530) 629-3111Primary Fax (530) 629-3122wwwopendoorhealthcom
opendoorMon - Fri 830 AM - 500 PMSat 900 AM - 1200 PM
Family MedicineBensky Norman D MD ^170^
diams Family MedicineNPI 1376506725License G54910Gender Male
Manning Jane Elizabeth PA ^171^
NPI 1376674598License PA11573Gender FemaleZertuche Kara S NP ^172^
NPI 1619272952License 20525Gender Female
Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 440lbs
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
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Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 33 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Hospitals Primary
Jerold Phelps Community Hospital ^173^
PHC 6039
NPI 1003819376License 110000052733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-4433wwwshchdorg24 Hours 7 Days a Week
Mad River Community Hospital ^174^
PHC 2020
NPI 1518996040License 1100000313800 Janes RdArcata CA 95521 Skilled Medical Interpreter ServicePrimary Phone (707) 822-3621Primary Fax (707) 825-4931wwwmadriverhospitalcom24 Hours 7 Days a Week
Redwood Memorial Hospital ^175^
PHC 2741
NPI 1043292303License 1100001733300 Renner DrFortuna CA 95540 Skilled Medical Interpreter ServicePrimary Phone (707) 725-3361wwwstjoehumboldtorg24 Hours 7 Days a Week
St Joseph Hospital ^176^
PHC 3047
NPI 1609858950License 1100000752700 Dolbeer StEureka CA 95501 Skilled Medical Interpreter ServicePrimary Phone (707) 445-8121Primary Fax (707) 269-3872wwwstjoehumboldtorg24 Hours 7 Days a Week
Hospitals Referral
CPMC-California Campus ^177^
PHC 1646
NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week
CPMC-Davies Campus ^178^
PHC 3969
NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-Pacific Campus ^179^
PHC 1646
NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
CPMC-St Lukes Campus ^180^
PHC 1872
NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week
Childrens Hospital Oakland ^181^
PHC 1560
NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 34 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Feather River Hospital ^182^
PHC 2446
NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg
feather-river24 Hours 7 Days a Week
John Muir Medical Center-Concord Campus ^183^
PHC 1559
NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week
Lodi Memorial Hospital ^184^
PHC 1379
NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg
lodimemorial24 Hours 7 Days a Week
Mercy General Hospital ^185^
PHC 2027
NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week
Mercy Hospital of Folsom ^186^
PHC 1733
NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week
Mercy San Juan Hospital ^187^
PHC 2026
NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week
Methodist Hospital of Sacramento
^188^
PHC 2029
NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week
Shriners Hospitals for Children ^189^
PHC 24564
NPI 1679915565License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week
St Elizabeth Community Hospital ^190^
PHC 5072
NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 35 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Sutter Medical Center Sacramento ^191^
PHC 1933
NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week
UC Davis Medical Center ^192^
PHC 2302
NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu
medicalcenter24 Hours 7 Days a Week
UCSF Medical Center ^193^
PHC 1555
NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week
Vibra Hospital of Sacramento ^194^
PHC 29489
NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week
Zuckerberg San Francisco General Hospital ^195^
PHC 1558
NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week
Mental Health Services - Outpatient
Beacon Health Strategies ^196^
Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom
member_loginaspx
You may email Beacon Member Services at MemberServicebeaconhscom
Pharmacy Network List
BARNES ARCATA FAMILY DRUG ^197^
NPI 18019686801080 G STREETARCATA CA 95521 Primary Phone (707) 822-1717Primary Fax (707) 822-1719Mon - Fri 900 AM - 700 PM
CLONEYS LONG TERM CARE PHARMACY ^198^
NPI 1164713517525 5TH ST SUITE BEUREKA CA 95501 Primary Phone (707) 443-8452Primary Fax (707) 443-2443Mon - Fri 900 AM - 600 PMSat 800 AM - 1200 PM
CLONEYS MCKINLEYVILLE PHARMACY ^199^
NPI 13961631761567 CITY CENTER RDMCKINLEYVILLE CA 95519 Primary Phone (707) 840-9923Primary Fax (707) 840-9928Mon - Fri 830 AM - 600 PMSat 900 AM - 100 PM
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 36 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
CLONEYS PRESCRIPTION PHARMACY ^200^
NPI 16392749882515 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 443-7086Primary Fax (707) 443-0302Mon - Fri 830 AM - 600 PM
CLONEYS RED CROSS PHARMACY ^201^
NPI 1720009798525 5TH STEUREKA CA 95501 Primary Phone (707) 443-1614Primary Fax (707) 443-4461Mon - Fri 900 AM - 600 PMSat 1200 PM - 400 PM
COSTCO PHARMACY ^202^
NPI 11948357931006 W WABASHEUREKA CA 95501 Primary Phone (707) 441-0920Primary Fax (707) 441-0923Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM
CVS PHARMACY ^203^
NPI 1861435653600 F STARCATA CA 95521 Primary Phone (707) 822-2479Primary Fax (707) 822-1810Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^204^
NPI 15684053061105 MYRTLE AVEEUREKA CA 95501 Primary Phone (707) 443-5081Primary Fax (707) 443-3622Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^205^
NPI 1144262973800 W HARRIS ST STE 20EUREKA CA 95503 Primary Phone (707) 443-8311Primary Fax (707) 443-2784Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM
CVS PHARMACY ^206^
NPI 12654548702525 4TH STEUREKA CA 95501 Primary Phone (707) 442-0549Primary Fax (707) 442-0549Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM
CVS PHARMACY 10513 ^207^
NPI 16799981081720 CENTRAL AVEMCKINLEYVILLE CA 95519 Primary Phone (707) 839-5621Primary Fax (707) 839-2867Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM
EUREKA VA CBOC PHARMACY ^208^
NPI 1689867632930 W HARRIS STEUREKA CA 95503 Primary Phone (707) 269-7546Primary Fax (707) 269-7557Mon - Fri 800 AM - 500 PM
GREENS FORTUNA PHARMACY ^209^
NPI 1881806610906 MAIN STFORTUNA CA 95540 Primary Phone (707) 725-4431Primary Fax (707) 725-2671Mon - Fri 900 AM - 700 PMSat 900 AM - 400 PM
KEITHS PHARMACY LLC ^210^
NPI 1841286903875 REDWOOD DRGARBERVILLE CA 95542 Primary Phone (707) 923-2461Primary Fax (707) 923-4038Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
KIMAW MEDICAL CENTER PHARMACY ^211^
NPI 1326217829535 AIRPORT RD SUITE 104HOOPA CA 95546 Primary Phone (530) 625-4114Primary Fax (530) 625-4312Mon - Fri 900 AM - 600 PM
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 37 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
LIMAS PROFESSIONAL PHARMACY ^212^
NPI 17706326552097 HARRISON AVEEUREKA CA 95501 Primary Phone (707) 441-8500Primary Fax (707) 443-7608Mon - Fri 900 AM - 600 PM
PALCO PHARMACY ^213^
NPI 1255322863113 MAIN ST STE DSCOTIA CA 95565 Primary Phone (707) 764-3591Primary Fax (707) 764-3797Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM
RINGS PHARMACY ^214^
NPI 1194885129362 MAIN STFERNDALE CA 95536 Primary Phone (707) 786-4511Primary Fax (707) 786-4500Mon - Fri 900 AM - 600 PMSat 900 AM - 230 PM
RITE AID PHARMACY 06036 ^215^
NPI 1912913203411 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 443-8039Primary Fax (707) 443-1281Mon - Fri 800 AM - 800 PMSat 900 AM - 800 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06037 ^216^
NPI 19726124631500 ANNA SPARKS WAY SUITE DMCKINLEYVILLE CA 95519 Primary Phone (707) 839-0140Primary Fax (707) 839-0251Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
RITE AID PHARMACY 06041 ^217^
NPI 1881703296725 SOUTH FORTUNA BOULEVARDFORTUNA CA 95540 Primary Phone (707) 725-9314Primary Fax (707) 725-4056Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
SAFEWAY PHARMACY 2908 ^218^
NPI 19920157962555 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 269-0114Primary Fax (707) 269-7193Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM
UNITED INDIAN HEALTH SERVICES PHARMACY ^219^
NPI 19827822561600 WEEOT WAYARCATA CA 95521 Primary Phone (707) 825-5020Primary Fax (707) 825-6879Mon - Fri 830 AM - 530 PM
WALGREENS ^220^
NPI 12159425941424 BROADWAY STEUREKA CA 95501 Primary Phone (707) 441-1900Primary Fax (707) 441-0681Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^221^
NPI 16694879552525 HARRIS STREETEUREKA CA 95503 Primary Phone (707) 444-0521Primary Fax (707) 444-0525Mon - Fri 900 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALGREENS ^222^
NPI 16292977341065 S FORTUNA BLVDFORTUNA CA 95540 Primary Phone (707) 726-0377Primary Fax (707) 726-0383Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM
WALMART PHARMACY 10-5629 ^223^
NPI 18718509333300 BROADWAY STE DEUREKA CA 95501
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 38 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Primary Phone (707) 832-5274Primary Fax (707) 832-5270Mon - Fri 900 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM
WILLOW CREEK PHARMACY ^224^
NPI 145746403439050 HWY 299WILLOW CREEK CA 95573 Primary Phone (530) 629-3144Primary Fax (530) 629-4303Mon - Fri 900 AM - 530 PM
Skilled Nursing Long Term Care Facilities
Eureka Rehabilitation and Wellness Center ^225^
PHC 27256
NPI 18011937682353 23rd StEureka CA 95501 Primary Phone (707) 445-3261Primary Fax (707) 441-844924 Hours 7 Days a Week
Fortuna Rehabilitation and Wellness Center ^226^
PHC 26738
NPI 17203854202321 Newburg RdFortuna CA 95540 Primary Phone (707) 725-4467Primary Fax (707) 725-184824 Hours 7 Days a Week
Granada Rehabilitation and Wellness Center ^227^
PHC 26347
NPI 10031137052885 Harris StEureka CA 95503 Primary Phone (707) 443-1627Primary Fax (707) 441-844624 Hours 7 Days a Week
Jerold Phelps Community Hospital ^228^
PHC 6039
NPI 1245458421733 Cedar StGarberville CA 95542 Skilled Medical Interpreter ServicePrimary Phone (707) 923-3921Primary Fax (707) 923-443324 Hours 7 Days a Week
Pacific Healthcare and Rehabilitation Center ^229^
PHC 28932
NPI 14778503372211 Harrison AveEureka CA 95501 Primary Phone (707) 443-9767Primary Fax (707) 441-844724 Hours 7 Days a Week
Seaview Rehabilitation amp Wellness Center ^230^
PHC 28927
NPI 13162442886400 Purdue DrEureka CA 95503
Primary Phone (707) 443-5668Primary Fax (707) 441-844824 Hours 7 Days a Week
Vision Service Plan (VSP) (1-800-877-7195)
Brian D Calvert OD ^231^
NPI 17907780173429 Renner DrFortuna CA 95540Primary Phone (707) 725-5255Primary Fax (707) 725-8833Mon - Thu 900 AM - 500 PM
Calvert Brian D OD ^232^
NPI 1790778017License 11045Gender MaleSpanish
Douglas H Lanning OD ^233^
NPI 19624910012437 Buhne StEureka CA 95501Primary Phone (707) 443-4581Primary Fax (707) 269-7137Mon - Fri 830 AM - 500 PM
Lanning Douglas H OD ^234^
NPI 1750449211License 12163Gender MaleRyan Daniel J OD ^235^
NPI 1962491001License 6545Gender Male
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 39 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST
HUMBOLDT COUNTY DIRECTORY
Fortuna Optometry ^236^
NPI 1437346400630 9th StFortuna CA 95540Primary Phone (707) 725-5144Primary Fax (707) 725-3511Mon - Fri 900 AM - 530 PM
French Alan E OD ^237^
NPI 1699709964License 5668Gender MaleSpanish
Kenneth L Kaiser OD ^238^
NPI 1770635831616 H StEureka CA 95501Primary Phone (707) 444-2968Primary Fax (707) 444-2968Mon - Fri 1000 AM - 500 PM
Kaiser Kenneth L OD ^239^
NPI 1770635831License 6259Gender MaleFrench
The Vision Center ^240^
NPI 1548223571616 H StEureka CA 95501Primary Phone (707) 443-1619Primary Fax (707) 443-1697Mon Wed - Fri 830 AM - 500 PMTue 800 AM - 500 PM
Domanchuk Paul M OD ^241^
NPI 1548223571License 8073Gender Male
Zuzana R Gellner OD ^242^
NPI 15685242132369 Harrison AveEureka CA 95501Primary Phone (707) 442-1472Primary Fax (707) 442-2723Mon - Fri 900 AM - 500 PM
Gellner Zuzana R OD ^243^
NPI 1568524213License 9561Gender Female
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 40 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
INDEX
A
Abels Gloria Beth MD 24Alston Gerald Anthony MD 21Arcata 19 20 21 22
B
Baird Donald I MD 25 26 27Barnes Robin L FNP 30Basch Corinne Vivian MD 19Battles Mandi Lisette PA 30Beach Sarah Darlene FNP 28Bell Norman Joseph MD 19Bensky Norman D MD 32Bosserman Mariel A ANP 21Brinckhaus Ruben E MD 27Brubaker Andrea B FNP 23Burns Judy A MD 21Buxbaum Evan R MD 28
C
Calvert Brian D OD 38Candiotti Linda Helene PA-C 28Carlson William Peter MD 29Cassel Kathleen M MD 22Cataldo Stuart D MD 24Chase Emmett MD 29Christensen Anne E DO 22Coleman John K PA-C 28Copple Nathan R MD 30
D
Dennis Tamara Smith MD 25Denton Heidi M DO 21 24Dietz Suzanne Michaels NP 23Dittmer Stephanie Suzanne MD 27Domanchuk Paul M OD 39Downie-Allman Fannette R NP 27
E
Ebel Valerie J MD 30Ellis Mark G MD 23Estlin Katherine A MD 26Eureka 22 23 24 25
F
Ferndale 25 26Fisher Patricia L NP 24Fittinghoff Leslie A MD 23Flowers Amber D NP 24Fortuna 26 27 28Fowler Vickie L NP 21
French Alan E OD 39
G
Gadallah Yousri E MD 28Garberville 28 29Geller Marc B PA-C 23Gellner Zuzana R OD 39Goodwin Gregory T PA 30Goodwin Nina Bleue NP 30
H
Hall Laura E FNP 20Hall Sacha B PA-C 30Hatch Deborah Ann NP 19Hatchimonji Rachel L NP 24Hawk Heather J NP 26Hayes Barbara Ann NP 29Hegdal Juliet Karen FNP 30Heiob Roxane K FNP 27Honda Malia Ann Kiyomi MD 23Hong May C MD 25Hoopa 29Hoopman Eloi J DO 21Horwitz David J PA 19Hospitals Primary 33Hospitals Referral 33 34 35Hovorka Gail Scott MD 24Hoyt Lisa M NP 19 23Hunter Willard Merrell MD 22
J
James Amanda B NP 24Johnson Libre E MD 24
K
Kaiser Kenneth L OD 39Kelly Casey N PA 23Kent Hugh D MD 22 32Kessler Bruce E MD 24Killfoil James J MD 28Krause Abigail B PA 23Kuhfahl Petra MD 24Kummerling Marissa L MD 22
L
Ladika Courtney C MD 25Lake Kristen N FNP 25Lam Dung Gloria T NP 21Langhurst Tracy L PA-C 29Lanning Douglas H OD 38Lee Sandra Y NP 31
Lowry Caroline A PA-C 21Lyons Laura L NP 30
M
Mahan Marcelle Owens MD 29Manning Jane Elizabeth PA 32Martinez Antoinette Patricia MD 22Martini Jenna R DO 21 30Maynor Audrey C PA-C 19McAtasney Grace Elaine NP 22 27McAtee Joni L MD 26McCurtain Loretta R NP 21McKinleyville 29 30Medina David M PA-C 26Mehta Rohan V MD 25Mental Health Services - Outpatient 35Metcalfe Kristen Zoe PA 23Meyers Mary A NP 31Mosher-Carbiener Charmaine Marie NP 23Moss Tara S PA 19Murray Angela N PA-C 26
N
Norvell Cindy J MD 19
O
Ohnemus Julie Marie MD 21Olkin Philip L MD 28Orleans 30
P
Palacios Alison M DO 20 32Pharmacy Network List 35 36 37 38Poterack Catherine D MD 20Proudfoot Jacqueline J MD 26
R
Raymer Terry W MD 22Redway 30Reese Barbara F NP 27Rice Ashley M FNP 23Robertson Anna DO 19Rousselot Anthony Max PA 22 27Royster Marilyn H FNP 25Rucker Mylene M MD 28Ryan Daniel J OD 38
S
Schafle Michael F MD 31Scheel Philip Richard MD 30
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Page 41 of 41
To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T
Revised Date May 4 2018
PHC PROVIDER INDEX | HUMBOLDT COUNTY DIRECTORY
Scher Sarah Anne MD 19Scotia 31Shegog Margarette J MD 26Skilled Nursing Long Term Care Facilities 38Smith Eva M MD 29Smith Kathy S FNP 25Spellmeyer Elizabeth E FNP 30Steele Lauren E MD 23Steinberg Miriam Dena DO 24Stokes Deepak Kumar MD 23Stollmeyer Kathryn M PA 32Stroup Allegra Beatrice FNP 23Sweitzer Deborah S PA 22
T
Taylor Ellen E PA 23Tinkelenberg James W PA 31
V
Vasquez Tony Escalona MD 30Vision Service Plan (VSP)
(1-800-877-7195) 38 39Vu Kelvin K DO 21 24Vu Tara Arness MD 30
W
Walsh Susan N NP 29Weiss Ellen A MD 19Weitchpec 31 32Werner Whitney M PA 27West Christopher Eugene NP 23Wilke Allan J MD 24Willow Creek 32Wizes Veronica Renee NP 20
Y
Young-Tripp Sawar C MD 32
Z
Zertuche Kara S NP 32Zwerling Alden P MD 19
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
Phone (800) 863-4155
httpwwwpartnershiphporg
Revision Date May 4 2018
