OrganizationActive
Prima Medical Foundation Sebastopol
NPI 1154590958 · Multi-Specialty Clinic/Center · Sebastopol, CA
Provider details
- NPI number
- 1154590958
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Prima Medical Foundation
- Organization subpart
- Yes
- Authorized official
- Dennis Mondragon, Coo(415) 884-1840
Specialties & taxonomies
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
652 Petaluma Ave
Suite H
Sebastopol, CA 95472-4256
Phone: (707) 823-7616
Fax: (707) 823-2803
Street-level locationGet directions
Mailing address
4 Hamilton Lndg Ste 100
Novato, CA 94949-8247
Other names (DBA / former)
- Doing business as
- Prima Medical Group
Registry dates
- Enumerated
- 2008-02-26
- Last updated
- 2013-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.