PACIFIC CENTRAL COAST HEALTH CENTERS (NPI# 1629421979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629421979 |
| Entity Type | Organization |
| Organization Name | PACIFIC CENTRAL COAST HEALTH CENTERS |
| Other Organization Name | LASSEN MEDICAL CLINIC - RED BLUFF |
| Practice Address |
2450 Sister Mary Columba Dr Red Bluff CA 96080-4356 |
| Mailing Address |
117 W Bunny Ave Santa Maria CA 93458-2805 |
| Practice Telephone | 5305270414 |
| Practice Fax Number | 5305284423 |
| Mailing Telephone | 8057393474 |
| Mailing Fax Number | 8056145956 |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2018-11-12 |
| Authorized Official Name | MATTHEW RICHARDSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8057393108 |
| Is Organization Subpart | Y |
| Parent Organization Name | PACIFIC CENTRAL COAST HEALTH CENTERS |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IRS | ========= | 01 |
| Other Name | Type Code |
|---|---|
| Lassen Medical Clinic - Red Bluff | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555061 | Pacific Central Coast Health Centers | Clinic/Center | 1560 Mesa Rd, Ste 101, Nipomo, CA 93444 | 2020-10-15 |
| 1841829876 | Pacific Central Coast Health Centers | Clinic/Center | 1992 Old Mission Dr Ste 140, Solvang, CA 93463-2302 | 2020-04-02 |
| 1396387569 | Pacific Central Coast Health Centers | Clinic/Center | 3807 Union Ave # B, Bakersfield, CA 93305-2400 | 2019-10-09 |
| 1861965055 | Pacific Central Coast Health Centers | Clinic/Center | 850 Fair Oaks Ave Ste 310, Arroyo Grande, CA 93420 | 2019-01-10 |
| 1023523990 | Pacific Central Coast Health Centers | Clinic/Center | 2271 S Depot St, Santa Maria, CA 93455-1216 | 2017-12-13 |
| 1306225941 | Pacific Central Coast Health Centers | Clinic/Center | 1102 E Clark Ave, Suite 120a, Santa Maria, CA 93455-5174 | 2015-05-28 |
| 1598002537 | Pacific Central Coast Health Centers | Clinic/Center | 689 Tank Farm Rd Ste 220, San Luis Obispo, CA 93401-7079 | 2013-01-10 |
| 1063496651 | Pacific Central Coast Health Centers | Clinic/Center | 117 W Bunny Ave, Santa Maria, CA 93458-2805 | 2005-12-06 |
| 1356949291 | Pacific Central Coast Health Centers | Clinic/Center | 3418 Loma Vista Rd Ste B, Ventura, CA 93003-3065 | 2020-10-13 |
| 1821610239 | Pacific Central Coast Health Centers | Clinic/Center | 1300 E Cypress St Ste B1, Santa Maria, CA 93454-4730 | 2020-05-08 |
| Street Address |
2450 SISTER MARY COLUMBA DR |
| City | RED BLUFF |
| State | CA |
| Zip Code | 96080-4356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659352219 | Derrick Hendricks Adams | Dermatology | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2005-11-10 |
| 1962055236 | Joseph Eischen | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2019-07-16 |
| 1407348147 | Dignity Health | Clinical Medical Laboratory | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2018-05-30 |
| 1609387661 | Maura Thoenes Buckley | Physician Assistant | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2017-10-18 |
| 1871004044 | Robin E Pendleton | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2017-10-16 |
| 1255850640 | Margaret A Macdonald | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2017-09-17 |
| 1801317177 | Anna Elizabeth Lalaguna | Nurse Practitioner | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2017-06-27 |
| 1063949550 | Kate Ashley Ellis | Physician Assistant | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2017-05-16 |
| 1528501038 | Rebecca Ann Hutchinson | Physician Assistant | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2016-12-01 |
| 1407399678 | Dignity Health | Clinic/Center | 2450 Sister Mary Columba Dr, Red Bluff, CA 96080-4356 | 2016-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578912408 | Gillian Lilo Prothro | Registered Nurse | 1425 Montgomery St., Red Bluff, CA 96080 | 2016-06-10 |
| 1154739373 | Gisela Vazquez Sandoval | Counselor | 818 Walnut St, Red Bluff, CA 96080 | 2014-07-31 |
| 1215348883 | Courtney Cathleen Coenen | Non-emergency Medical Transport (VAN) | 320 Michael Drive, Red Bluff, CA 96080 | 2014-05-16 |
| 1023451986 | Nhuha Thi Le | Registered Nurse | 1860 B Walnut St, Red Bluff, CA 96080 | 2013-04-10 |
| 1184991580 | Maria Arendina Los | Registered Nurse | 818 Main Street, Tehama County Health Services Agency, Red Bluff, CA 96080 | 2011-11-30 |
| 1558682195 | Metasebia Bekele | Physician Assistant | 1850 Walnut Street, Red Bluff, CA 96080 | 2010-06-17 |
| 1821314238 | Cynthia Louise Funderburk | Nurse's Aide | 1860 B Walnut Street, Red Bluff, CA 96080 | 2010-04-09 |
| 1285865485 | Phillip John Velador Jr. | Licensed Vocational Nurse | 1860b Walnut Street, Red Bluff, CA 96080 | 2009-08-05 |
| 1609010347 | Lori Kay Mccaughey | Registered Nurse | 1860b Walnut St, Red Bluff, CA 96080 | 2009-04-24 |
| 1467668616 | Tehama County Health Services Agency - Mental Health Division | Clinic/Center | 1860 Walnut Street, Suite A, B, D and J, Red Bluff, CA 96080 | 2007-05-15 |
| Find all providers in zip 96080 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194340794 | Greenville Rancheria | Clinic/Center | 13545 Saint Marys Ave, Red Bluff, CA 96080-8884 | 2020-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555061 | Pacific Central Coast Health Centers | Clinic/Center | 1560 Mesa Rd, Ste 101, Nipomo, CA 93444 | 2020-10-15 |
| 1891301578 | Vida Community Clinic | Clinic/Center | 1519 Woodworth St, San Fernando, CA 91340-4153 | 2020-09-18 |
| 1982210522 | Life Helping Hands Inc | Clinic/Center | 987 Haley Talbert Dr, Corona, CA 92881-8402 | 2020-09-18 |
| 1780292912 | Marin Community Clinic | Clinic/Center | 1260 S Eliseo Dr Ste 201, Greenbrae, CA 94904-2009 | 2020-07-14 |
| 1922625847 | Gardner Family Health Network | Clinic/Center | 1621 Gold St, Alviso, CA 95002-3530 | 2020-06-26 |
| 1841829876 | Pacific Central Coast Health Centers | Clinic/Center | 1992 Old Mission Dr Ste 140, Solvang, CA 93463-2302 | 2020-04-02 |
| 1740812866 | Tauna Mcginnis | Clinic/Center | 1570 Soquel Dr Ste 4, Santa Cruz, CA 95065-1715 | 2020-02-06 |
| 1275173403 | United Advocates for Children and Families | Clinic/Center | 2143 Hurley Way Ste 102, Sacramento, CA 95825-3297 | 2020-01-15 |
| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| 1841836301 | Beverlycare | Clinic/Center | 101 E Beverly Blvd Ste 301, Montebello, CA 90640-4316 | 2019-11-20 |
| Find all providers with the same taxonomy | ||||
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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.