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CH09788D Petaluma Health Center, Inc. (Active)
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Main Details
Name
Petaluma Health Center, Inc.
Subdivision Name
San Antonio High School Health Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012778
340B ID
CH09788D
Grant Number
H80CS00587
Additional Details
Current Program Status
Active
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/17/2017
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Petaluma Health Center
Molly Jouaneh, Chief Financial Officer
(707) 559-7500
Primary Contact
Petaluma Health Center
Pedro Toledo, Chief Executive Officer
(707) 326-7551
Addresses
Street Address
500 Vallejo St
Petaluma, CA 94952-3364
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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