# ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adventist Health Clear Lake
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871063040
- **Authorized official:** PARKER J PRIDGEN (PRESIDENT)
- **Authorized official phone:** (707) 467-5200

## Contact information

- **Practice address:** 801 11TH ST, LAKEPORT, CA 95453-4100
- **Practice address phone:** (707) 263-3746
- **Mailing address:** PO BOX 888837, LOS ANGELES, CA 90088-8837

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/30/2018
- **Last updated:** 09/15/2025