Mendocino Community Health Clinic, Inc.
NPI 1770516304 · Federally Qualified Health Center (FQHC) · Lakeport, CA
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mendocino Community Health Clinic, Inc. is a Federally Qualified Health Center (FQHC) organization in Lakeport, CA (NPI 1770516304).
Provider details
- NPI number
- 1770516304
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tim Dolan, Cfo(707) 467-2260
- License
- 110000350 (CA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
Mailing address
Other names (DBA / former)
- Other name
- Lakeside Health Center
- Other name
- Lakeside Health Center
Registry dates
- Enumerated
- 2006-07-08
- Last updated
- 2019-05-03
Frequently asked questions
- What is Mendocino Community Health Clinic, Inc.'s NPI number?
- Mendocino Community Health Clinic, Inc.'s National Provider Identifier (NPI) is 1770516304, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mendocino Community Health Clinic, Inc.?
- Mendocino Community Health Clinic, Inc. is classified in the NPPES registry as Federally Qualified Health Center (FQHC) (Ambulatory Health Care Facilities).
- Where is Mendocino Community Health Clinic, Inc. located?
- Mendocino Community Health Clinic, Inc.'s practice location on file with NPPES is 5335 Lakeshore Blvd, Lakeport, CA 95453-6123.
- What is Mendocino Community Health Clinic, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Mendocino Community Health Clinic, Inc. is (707) 263-7725.
- Does Mendocino Community Health Clinic, Inc. accept Medicare?
- Mendocino Community Health Clinic, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mendocino Community Health Clinic, Inc.?
- The authorized official listed on Mendocino Community Health Clinic, Inc.'s NPPES record is Tim Dolan, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mendocino Community Health Clinic, Inc.'s NPI active?
- Yes — Mendocino Community Health Clinic, Inc.'s NPI (1770516304) is active in the NPPES registry as of the last update on 2019-05-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.