OrganizationActive
Southern Trinity Health Inc
NPI 1053595744 · Federally Qualified Health Center (FQHC) · Mad River, CA
Provider details
- NPI number
- 1053595744
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Graylan Lupton, Chief Executive Officer(707) 574-6616
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
153-A Van Duzen Rd
Mad River, CA 95552
Phone: (707) 574-6616
Fax: (707) 574-6523
Street-level locationGet directions
Mailing address
Po Box 7
Scotia, CA 95565-0007
Registry dates
- Enumerated
- 2007-12-18
- Last updated
- 2022-04-21
- Certified
- 2022-04-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.