LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. (NPI# 1285000810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285000810 |
| Entity Type | Organization |
| Organization Name | LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC. |
| Practice Address |
14678 Lakeshore Boulevard Clearlake CA 95453 |
| Mailing Address |
Po Box 1950 Lakeport CA 95453-1950 |
| Practice Telephone | 7072628382 |
| Mailing Telephone | 7072638382 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |
| Authorized Official Name | MR. ERNESTO PADILLA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5412638382 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 110000289 | CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215327804 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 359 Lakeport Blvd, Lakeport, CA 95453-5412 | 2015-02-03 |
| 1528402336 | Lake County Tribal Health Consortium, Inc. | Pharmacy | 925 Bevins Ct, Lakeport, CA 95453-9754 | 2013-04-23 |
| Street Address |
14678 LAKESHORE BOULEVARD |
| City | CLEARLAKE |
| State | CA |
| Zip Code | 95453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| 1952429052 | Annette Joyce Moynier | Marriage & Family Therapist | 1152 South Main Street, Lakeport, CA 95453 | 2007-03-27 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053272 | West Sacramento Primary Care Inc. | Clinic/Center | 2455 Jefferson Blvd Ste 100, West Sacramento, CA 95691-5329 | 2020-11-06 |
| 1306447941 | Bedford Breast Surgeons | Clinic/Center | 436 North Bedford Drive, Suite 105, Beverly Hills, CA 90210-4323 | 2020-11-02 |
| 1538767082 | County of Los Angeles | Clinic/Center | 6902 Atlantic Ave, Bell, CA 90201-3647 | 2020-10-15 |
| 1225636855 | Optimum Wellness and Weight Loss | Clinic/Center | 910 S El Camino Real Ste 100, San Clemente, CA 92672-4279 | 2020-10-15 |
| 1932707700 | Body By Design Wellness and Massage Clinic, Inc. | Clinic/Center | 3625 E Thousand Oaks Blvd Ste 215216, Westlake Village, CA 91362-3626 | 2020-10-14 |
| 1639786189 | Rams Ppe | Clinic/Center | 15329 Bonanza Rd Ste D, Victorville, CA 92392-2457 | 2020-09-29 |
| 1720695729 | Vila Facial Plastic Surgery | Clinic/Center | 1000 S Eliseo Dr Ste 203, Greenbrae, CA 94904-2151 | 2020-09-24 |
| 1902410442 | Hope Elementary School District | Clinic/Center | 3970 La Colina Rd Ste 14, Santa Barbara, CA 93110-1596 | 2020-09-02 |
| 1558974097 | Jiseki Health Inc | Clinic/Center | 1150 S King Rd Ste 40, San Jose, CA 95122-2140 | 2020-08-25 |
| 1902417678 | I-ma Acupuncture Inc | Clinic/Center | 2485 High School Ave Ste 123, Concord, CA 94520-1812 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LAKE COUNTY TRIBAL HEALTH CONSORTIUM, 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.