Detail by Officer/Registered Agent Name
Foreign Not For Profit Corporation
PROVIDENCE MEDICAL FOUNDATION INC.
Cross Reference Name
PROVIDENCE MEDICAL FOUNDATION
Filing Information
F22000001452
33-0185031
03/10/2022
CA
ACTIVE
Principal Address
Changed: 02/20/2023
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Changed: 02/20/2023
Mailing Address
Changed: 02/20/2023
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Changed: 02/20/2023
Registered Agent Name & Address
C T CORPORATION SYSTEM
1200 SOUTH PINE ISLAND ROAD
PLANTATION, FL 33324
PLANTATION, FL 33324
Officer/Director Detail
Name & Address
Title Director
Barcellona, William
Title Director
Bartlett, Connie , DO
Title Director
Benoit, James Dr.
Title Director
Currie, Jeannette , MD
Title Director
Ford, Anne , MD
Title Director
Marquez, Raul , MD
Title Director
Marter, Roscoe
Title Director
Marton, Keith , MD
Title Director
Needham, Mark
Title Director
Santore, Ali
Title Director
Sugarman, Michael , MD
Title Director
Vaezy, Sara
Title Director
Wexler, Erik G.
Title Secretary
Watson, James D.
Title CFO
Yocum , Connie Melayne
Title PRESIDENT
MOHANTY, PRASANNA
Title DIRECTOR
PARDOE, MARK
Title DIRECTOR
CHAN, KIMBERLEY
Title DIRECTOR
DUPLECHAN, JILL
Title DIRECTOR
FERREY, ANTONIO
Title DIRECTOR
MAST, DAVID
Title Director
Just, Bob
Title Director
Barcellona, William
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Bartlett, Connie , DO
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Benoit, James Dr.
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Currie, Jeannette , MD
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Ford, Anne , MD
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Marquez, Raul , MD
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Marter, Roscoe
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Marton, Keith , MD
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Needham, Mark
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Santore, Ali
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Sugarman, Michael , MD
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Vaezy, Sara
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Wexler, Erik G.
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Secretary
Watson, James D.
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title CFO
Yocum , Connie Melayne
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title PRESIDENT
MOHANTY, PRASANNA
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title DIRECTOR
PARDOE, MARK
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title DIRECTOR
CHAN, KIMBERLEY
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title DIRECTOR
DUPLECHAN, JILL
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title DIRECTOR
FERREY, ANTONIO
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title DIRECTOR
MAST, DAVID
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Title Director
Just, Bob
200 W. Center Street Promenade, Suite 800
Anaheim, CA 92805
Anaheim, CA 92805
Annual Reports
| Report Year | Filed Date |
| 2023 | 02/20/2023 |
| 2024 | 02/07/2024 |
Document Images
| 02/07/2024 -- ANNUAL REPORT | View image in PDF format |
| 02/20/2023 -- ANNUAL REPORT | View image in PDF format |
| 03/10/2022 -- Foreign Non-Profit | View image in PDF format |