Lake County Tribal Health Southshore Clinic
Lake County Tribal Health Southshore Clinic is a Federally Qualified Health Center (FQHC) in Clearlake, California. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
14440 Olympic DrClearlake, CA 95422
Phone: (707) 263-8382
Fax: (707) 263-5019
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Federally Qualified Health Center (FQHC) (primary) | Taxonomy 261QF0400X |
|---|
Record details
| NPI number | 1063158038 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Lake County Tribal Health Consortium Inc |
| Authorized official | Ernesto Padilla — Ceo · (707) 263-8382 |
| NPI enumerated | May 11, 2022 |
| Last updated in NPPES | April 2, 2024 |
| Certification date | April 2, 2024 |
| Mailing address | Po Box 1950, Lakeport, CA 95453-1950 |
Other providers in Clearlake
-
Lake County Tribal Health Consortium, Inc
14678 Lakeshore Blvd, Clearlake, CA 95453 · (707) 262-8382