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MENDOCINO COAST CLINICS INC
NPI 1083783757
Clinic/Center - Federally Qualified Health Center (FQHC) in Fort Bragg, CA

Active since November 07, 2006CLIA 05D0890246 · Microscopy
205 SOUTH STREET, FORT BRAGG, CA 95437(707) 964-1251(707) 961-2722 Get Directions Write a Review

NPPES record last updated: June 9, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 9, 2020, Oct 11, 2019 (2 updates tracked since 2019).

About Mendocino Coast Clinics Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MENDOCINO COAST CLINICS INC (NPI 1083783757) is a healthcare organization registered as a federally qualified health center (fqhc) in Fort Bragg, California and active in the NPI registry since November 2006. The organization holds a CLIA Microscopy certificate valid through September 9, 2026 and lists Lucresha Renteria, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1083783757
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMENDOCINO COAST CLINICS INC
Location Address205 SOUTH STREETFort Bragg, CA 95437-5540
Mailing Address205 South StreetFort Bragg, CA 95437-5540 · (707) 964-1251 · Fax (707) 961-2722
Phone(707) 964-1251
Fax(707) 961-2722
Organization SubpartNo
Authorized OfficialLucresha RenteriaExecutive Director · (707) 964-1251
Enumeration DateNovember 7, 2006
Last NPPES UpdateJune 9, 20202 updates tracked since enumeration
NPPES CertifiedJune 9, 2020
✔ NPI 1083783757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
205 SOUTH STREET, Fort Bragg, CA 95437
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Other Identifiers 2

MedicaidFHC03967FCA
OtherZZZ15984ZCA · Medicare Part B Ptan

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0890246

Mendocino Coast Clinics · Fort Bragg, CA
Active · expires Sep 9, 2026
CLIA Number05D0890246
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateSeptember 10, 2024
Certificate Expiration DateSeptember 9, 2026
Laboratory DirectorLawrence Goldyn
Laboratory Phone(707) 964-1251
Laboratory LocationMendocino Coast Clinics205 South St, Fort Bragg, CA 95437
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISOL GONZALEZ-ROBLES DENTAL HYGIENIST
Dental Hygienist
205 SOUTH STREET
FORT BRAGG, CA 95437
Mendocino County (707) 964-1252
MARCIE MLISS MAXHAM DDS
Dentist
205 SOUTH STREET
FORT BRAGG, CA 95437
Mendocino County (707) 964-1251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mendocino Coast Clinics Inc's NPI number?

The NPI number for Mendocino Coast Clinics Inc is 1083783757. It was assigned to this organization in the NPPES registry on November 7, 2006.

Where is Mendocino Coast Clinics Inc located?

Mendocino Coast Clinics Inc is located at 205 South Street, Fort Bragg, CA 95437. The listed phone number is (707) 964-1251.

What is Mendocino Coast Clinics Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Mendocino Coast Clinics Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0890246) is associated with this NPI, valid through September 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mendocino Coast Clinics Inc was last updated on June 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.