ADVENTIST HEALTH CLEARLAKE HOSPITAL INC; NPI #1477104099

Contact Information

ADVENTIST HEALTH CLEARLAKE HOSPITAL INC

15322 LAKESHORE DRIVE
SUITE 101, 102 AND 201
CLEARLAKE, CA 95422

Phone: 707-461-7986
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for ADVENTIST HEALTH CLEARLAKE HOSPITAL INC

NPI #	`1477104099`
LBN Legal business name	ADVENTIST HEALTH CLEARLAKE HOSPITAL INC
Authorized official	PARKER PRIDGEN - (PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	09/25/2019
Last updated	09/15/2025 - About 9 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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