OrganizationActive
Adventist Health Clearlake Hospital Inc.
NPI 1962492876 · Rural Health Clinic/Center · Kelseyville, CA
Provider details
- NPI number
- 1962492876
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Parker Pridgen, President
- License
- 110000174 (CA)
Practice location
5290 State St
Kelseyville, CA 95451-9450
Phone: (707) 279-8813
Fax: (707) 279-2241
Mailing address
Po Box 888837
Los Angeles, CA 90088-8837
Registry dates
- Enumerated
- 2005-10-24
- Last updated
- 2025-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.