LUCERNE COMMUNITY CLINIC (NPI# 1376609198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376609198 |
| Entity Type | Organization |
| Organization Name | LUCERNE COMMUNITY CLINIC |
| Practice Address |
6300 E. Hwy 20 Lucerne CA 95458 |
| Mailing Address |
Po Box 1978 Lucerne CA 95458-1978 |
| Practice Telephone | 7072749299 |
| Practice Fax Number | 7072749297 |
| Mailing Telephone | 7072749299 |
| Mailing Fax Number | 7072749297 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | DR. ROBERT WILLIAM GARDNER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7072749299 |
| Authorized Official Credential | M.D. |
| 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 | RHM53967F | 05 |
| Street Address |
6300 E. HWY 20 |
| City | LUCERNE |
| State | CA |
| Zip Code | 95458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649243437 | Joseph Geare | Physician Assistant | 6300 E. Hwy 20, Lucerne, CA 95458 | 2006-02-10 |
| 1437652385 | Jennifer Sue Nauert | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458-9545 | 2018-03-16 |
| 1285963413 | Dr. Gardner Outpatient Program | Community/Behavioral Health | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-12-17 |
| 1023345857 | Robert W. Gardner Psg-dr. Gardner Outpatient Program | Community/Behavioral Health | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-11-16 |
| 1194969113 | Lori Carter-runyon | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2009-04-21 |
| 1235311630 | Elliott Bennett | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-11-28 |
| 1598958076 | Steve Mueller | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-08-20 |
| 1841401825 | Dennis Mason | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-24 |
| 1437360492 | Maureen Conway | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-24 |
| 1669680120 | James Wilkie | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458 | 2007-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527512 | Shawna Dee Theodorou | Case Manager/Care Coordinator | 6302 Thirteeth Ave, Lucerne, CA 95458 | 2019-09-13 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1750848396 | Catherine Denise Miller | Case Manager/Care Coordinator | 6302 13 Th Ave, Lucerne, CA 95458 | 2019-03-01 |
| 1043774193 | Priest Martinez | Counselor | 6300 E Hwy 20 Unit B, Lucerne, CA 95458 | 2019-01-23 |
| 1700308962 | Joao Adeles Barta | Case Manager/Care Coordinator | 6302 Thirteenth Av., Lucerne, CA 95458 | 2017-07-10 |
| 1154872737 | Deborah Annette Schmidt | Licensed Vocational Nurse | 6302 13th Ave., Lucerne, CA 95458 | 2016-10-19 |
| 1922496199 | Pearlina Drummond | Counselor | 3937 Foothill Drive, Lucerne, CA 95458 | 2014-12-22 |
| 1467881672 | Lucerne Elementary | Local Education Agency (LEA) | 3351 Country Club Drive, Lucerne, CA 95458 | 2013-11-07 |
| 1003245960 | Hilltop Recovery Services | Substance Abuse Rehabilitation Facility | 3937 Foothill Dr, Lucerne, CA 95458 | 2013-11-01 |
| 1053618652 | Chris Partida | Counselor | 6302 13th Ave, Lucerne, CA 95458 | 2011-02-16 |
| Find all providers in zip 95458 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
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| 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.