# COUNTY OF EL DORADO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730989286
- **Authorized official:** KACI SMITH (CHIEF PROBATION OFFICER)
- **Authorized official phone:** (530) 621-5625

## Contact information

- **Practice address:** 1041 AL TAHOE BLVD., SOUTH LAKE TAHOE, CA 96150-4502
- **Practice address phone:** (530) 621-7990
- **Mailing address:** 3974 DUROCK RD STE 205, SHINGLE SPRINGS, CA 95682-8568
- **Mailing address phone:** (530) 621-5625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2025
- **Last updated:** 10/15/2026