Organization
ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
Active
Other names
Adventist Health Clear Lake
Organization subpart
No
Provider details
NPI number
Authorized official
PARKER J PRIDGEN (PRESIDENT)
(707) 467-5200
Entity
Organization
Contact information
Practice address
15630 18TH AVE, CLEARLAKE, CA 95422-6710
(707) 994-6486
(707) 995-3631
Mailing address
PO BOX 888837, LOS ANGELES, CA 90088-8837
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
110000174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSP40539G
—
CA
05
—
ZZR00539G
—
CA
01
—
ZZZC1702Z
BLUE SHIELD INPATIENT
CA
Enumeration date
10/24/2005
Last updated
09/15/2025
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