| County Of Lake | |
|
7000b S Center Dr Clearlake CA 95422-8131 | |
| (707) 994-7090 | |
| (707) 994-7092 |
| Full Name | County Of Lake |
|---|---|
| Speciality | Clinic/Center |
| Location | 7000b S Center Dr, Clearlake, California |
| Authorized Official Name and Position | Elise Jones (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 7072749101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| County Of Lake Po Box 1024 Lucerne CA 95458-1024 Ph: (707) 274-9101 | County Of Lake 7000b S Center Dr Clearlake CA 95422-8131 Ph: (707) 994-7090 |
| NPI Number | 1326252271 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 08/10/2023 |
| Certification Date | 08/10/2023 |
| Medicare PECOS PAC ID | 2466495429 |
|---|---|
| Medicare Enrollment ID | O20050609001101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326252271 | NPI | - | NPPES |
| 1712 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (California) | Primary |
| Provider Name | Caroline Little Cribari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437185907 PECOS PAC ID: 9830160969 Enrollment ID: I20040803000976 |
| Provider Name | Martin A Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073653861 PECOS PAC ID: 8527080498 Enrollment ID: I20051220000990 |
| Provider Name | Thomas J Andrews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245393651 PECOS PAC ID: 7618015983 Enrollment ID: I20091130000432 |
| Provider Name | Socorro Padilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366858623 PECOS PAC ID: 1658634076 Enrollment ID: I20180418001355 |
| Provider Name | Darin E Gould |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376718023 PECOS PAC ID: 0749562635 Enrollment ID: I20201229002913 |
Lake County Community Action Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6840 S Center Dr, Clearlake, CA 95422 Phone: 707-995-1232 Fax: 707-995-7084 | |
Lake County Community Action Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15850 A Dam Road, Clearlake, CA 95422 Phone: 707-994-6447 Fax: 707-994-1875 | |
County Of Lake Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14092 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-994-4261 | |
Adventist Health California Medical Group, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15230 Lakeshore Dr, Clearlake, CA 95422 Phone: 707-995-4500 Fax: 707-994-2401 | |
County Of Lake Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7000b S Center Dr, Clearlake, CA 95422 Phone: 707-994-7090 Fax: 707-994-7092 | |
Lake County Community Action Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6885 Old Highway 53, Clearlake, CA 95422 Phone: 707-995-3235 Fax: 707-995-7004 |