OrganizationActive
Agewell Pace
NPI 1437833597 · General Practice Physician · Rohnert Park, CA
Provider details
- NPI number
- 1437833597
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Derrick Whitacre, Executive Director(707) 615-4437
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Registered Nurse163W00000X
Nursing Service Providers
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Practice location
5789 State Farm Dr Ste 110
Rohnert Park, CA 94928-6308
Phone: (707) 615-4437
Fax: (707) 615-6955
Approximate (ZIP-level) locationGet directions
Mailing address
5789 State Farm Dr Ste 110
Rohnert Park, CA 94928-6308
Registry dates
- Enumerated
- 2023-06-09
- Last updated
- 2023-06-09
- Certified
- 2023-06-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.