NPIMap

Organization Active NPI

St. Helena OB/GYN Clinic

  • Specialist
  • Clearlake, CA
National Provider Identifier
1376510586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ST. HELENA OB/GYN CLINIC
Practice address
15322 Lakeshore Dr
Suite 102
Clearlake, CA 95422-9814
Phone
(707) 995-0193
NPI assigned
Mar 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renee W Solomon
Title
Medical Group Coordinator
Phone
(707) 968-2870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

15322 Lakeshore Dr
Suite 102
Clearlake, CA 95422-9814

Mailing address

15322 Lakeshore Dr
Suite 102
Clearlake, CA 95422-9814
Phone (707) 995-0193

National Provider Directory

National Provider Directory
Tax ID family
Adventist Health California Medical Group Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376510586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15322 LAKESHORE DR",
            "address_2": "SUITE 102",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229814",
            "telephone_number": "707-995-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15322 LAKESHORE DR",
            "address_2": "SUITE 102",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954229814",
            "telephone_number": "707-995-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. HELENA OB/GYN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL GROUP COORDINATOR",
        "authorized_official_telephone_number": "707-968-2870"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.