NPIMap

Organization Active NPI

County of Lake

  • Community/Behavioral Health Agency
  • Clearlake, CA
National Provider Identifier
1619039211
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF LAKE
Practice address
7000B S Center Dr
Clearlake, CA 95422-8131
Phone
(707) 994-7090
Fax
(707) 994-7092
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Elise Jones, MA
Title
Behavioral Health Director
Phone
(707) 274-9101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CA Primary

Addresses

Primary practice location

7000B S Center Dr
Clearlake, CA 95422-8131

Mailing address

P O Box 1024
Lucerne, CA 95458
Phone (707) 274-9101

Other identifiers 1

IdentifierTypeStateIssuer
171712MedicaidCA

Other names 1

  • Lake County Behavioral Health Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Lake County Health Services Department12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1619039211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1024",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "95458",
            "telephone_number": "707-274-9101",
            "fax_number": "707-274-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000B S CENTER DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "954228131",
            "telephone_number": "707-994-7090",
            "fax_number": "707-994-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "707-274-9101",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171712",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake County Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 26, 2024; 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.