ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. (NPI# 1912092792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912092792 |
| Entity Type | Organization |
| Organization Name | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC. |
| Other Organization Name | ADVENTIST HEALTH CLEAR LAKE |
| Practice Address |
5125 Skyway Paradise CA 95969-5624 |
| Mailing Address |
Po Box 398837 San Francisco CA 94139-8837 |
| Practice Telephone | 5308722000 |
| Practice Fax Number | 5308767952 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | CARLTON EDWARD JACOBSON (CFO) |
| Authorized Official Telephone | 7079955824 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM08604F | 05 |
| Other Name | Type Code |
|---|---|
| Adventist Health And Rideout | Doing Business As Name - Organization |
| Adventist Health Clear Lake | Doing Business As Name - Organization |
| Adventist Health Feather River | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972593788 | Adventist Health Clearlake Hospital Inc. | Clinic/Center | 21337 Bush St, Middletown, CA 95461 | 2005-10-24 |
| 1962492876 | Adventist Health Clearlake Hospital Inc. | Clinic/Center | 5290 State St, Kelseyville, CA 95451-9450 | 2005-10-24 |
| 1124018031 | Adventist Health Clearlake Hospital Inc. | General Acute Care Hospital | 15630 18th Ave, Clearlake, CA 95422-6710 | 2005-10-24 |
| 1316937121 | Adventist Health Clearlake Hospital Inc. | Clinic/Center | 15230 Lakeshore Drive, Clearlake, CA 95422-6710 | 2005-10-24 |
| 1285054106 | Adventist Health Clearlake Hospital Inc. | Clinic/Center | 155 Solano St, Corning, CA 96021-3511 | 2014-04-17 |
| 1487897047 | Adventist Health Clearlake Hospital Inc. | General Acute Care Hospital | 15630 18th Ave, Clearlake, CA 95422 | 2009-04-13 |
| Street Address |
5125 SKYWAY |
| City | PARADISE |
| State | CA |
| Zip Code | 95969-5624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842933 | Brian Michael Estabrook | Physician Assistant | 5125 Skyway, Paradise, CA 95969-5624 | 2005-09-20 |
| 1033734926 | Lisa Cordova | Nurse Practitioner | 5125 Skyway, Paradise, CA 95969-5624 | 2020-06-16 |
| 1114582020 | Adventist Health Physicians Network | Internal Medicine | 5125 Skyway, Paradise, CA 95969-5624 | 2019-05-06 |
| 1891169330 | Feather River Hospital | General Acute Care Hospital | 5125 Skyway, Paradise, CA 95969-5624 | 2015-11-20 |
| 1457724239 | Christopher Jensen | Physician Assistant | 5125 Skyway, Paradise, CA 95969-5624 | 2015-11-03 |
| 1508232331 | Laura Jane Bethke | Nurse Practitioner | 5125 Skyway, Paradise, CA 95969-5624 | 2015-08-16 |
| 1982046793 | Noelle Evonne Gunn | Physician Assistant | 5125 Skyway, Paradise, CA 95969-5624 | 2013-07-22 |
| 1699014555 | Frank Tsolakis | Pharmacist | 5125 Skyway, Paradise, CA 95969-5624 | 2013-02-12 |
| 1851630032 | Chanin Jeanine Hanson | Registered Nurse | 5125 Skyway, Paradise, CA 95969-5624 | 2013-02-07 |
| 1942550132 | Lori Fox Goodliffe | Nurse Practitioner | 5125 Skyway, Paradise, CA 95969-5624 | 2012-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699234559 | Skala Chiropractic Inc | Chiropractor | 4413 Sierra Del Sol, Paradise, CA 95969 | 2019-03-19 |
| 1114463924 | Gary R Watts | Obstetrics & Gynecology | 5016 Lago Vista Way, Paradise, CA 95969 | 2017-01-18 |
| 1013367044 | Leslie Allison Bass | Registered Nurse | 1309 Nunneley Road, Paradise, CA 95969 | 2016-06-21 |
| 1457798977 | Lisa Marie Nelson | Counselor | 5910 Clark Road Suite 179, Paradise, CA 95969 | 2013-05-23 |
| 1700121597 | Ann Mary Sullivan | Marriage & Family Therapist | 955 Elliott Road, Paradise, CA 95969 | 2012-12-05 |
| 1255631693 | Paola Maria Mccarthy | Pharmacist | 6020 Clark Rd, Paradise, CA 95969 | 2010-11-02 |
| 1871821678 | Lisa Alison Franco | Occupational Therapist | 1633 Cypress Ln., Lifehouse/cypress, Paradise, CA 95969 | 2009-12-07 |
| 1700017548 | Michael C Reilly | Occupational Therapy Assistant | 1633 Cypress Lane, Paradise, CA 95969 | 2009-07-28 |
| 1992985899 | James D Salomone | Counselor | 7690 East Rd, Redwood Valley, CA 95969 | 2007-11-07 |
| 1548461619 | Paradise Ultrasound | Radiologic Technologist | 5921 Clark Rd, Ste. C, Paradise, CA 95969 | 2007-05-29 |
| Find all providers in zip 95969 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811044886 | Helen Newberry Joy Hospital | Clinic/Center | 7321 N M-123, Paradise, MI 49768 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699620 | Reedley Community Hospital | Clinic/Center | 398 S Church Road, Earlimart, CA 93219 | 2020-11-06 |
| 1174130942 | Kaweah Delta Health Care District | Clinic/Center | 1000 N Mooney Blvd, Tulare, CA 93274-2417 | 2020-09-25 |
| 1922614197 | Sierra View Local Health Care District | Clinic/Center | 9520 Road 238, Terra Bella, CA 93270 | 2020-09-22 |
| 1124643598 | Valley Healthcare Centers | Clinic/Center | 369 N Church Rd, Earlimart, CA 93219 | 2020-06-11 |
| 1477177210 | Anand Narayan Md Inc | Clinic/Center | 317 W El Monte Way, Dinuba, CA 93618-1557 | 2020-06-06 |
| 1902435894 | Slt Medical Group Inc | Clinic/Center | 2024 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6498 | 2020-04-03 |
| 1881232676 | Madera Community Hospital | Clinic/Center | 121 Belmont Ave., Suite 101, Mendota, CA 93640 | 2019-12-12 |
| 1790331817 | Valley Healthcare Centers | Clinic/Center | 252 N Highway 65, Lindsay, CA 93247-2702 | 2019-08-14 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ADVENTIST HEALTH CLEARLAKE HOSPITAL INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.