ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
NPI 1124018031
General Acute Care Hospital - Critical Access in Clearlake, CA
NPI Status: Active since October 24, 2005
Contact Information
15630 18TH AVE
CLEARLAKE, CA
ZIP 95422
Phone: (707) 994-6486
Fax: (707) 995-3631
- Organization
- General Acute Care Hospital
- Critical Access
- CLIA Number: 05D0611927
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 01-02-2027
About ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
This page provides the complete NPI Profile along with additional information for Adventist Health Clearlake Hospital Inc., a provider established in Clearlake, California operating as a General Acute Care Hospital, focusing in critical access . The healthcare provider is registered in the NPI registry with number 1124018031 assigned on October 2005. The practitioner's primary taxonomy code is 282NC0060X with license number 110000174 (CA). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1124018031
- Provider Legal Name
- ADVENTIST HEALTH CLEARLAKE HOSPITAL INC.
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 15630 18TH AVE CLEARLAKE, CA 95422
- Location Phone
- (707) 994-6486
- Location Fax
- (707) 995-3631
- Mailing Address
- PO BOX 888837 LOS ANGELES, CA 90088
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-24-2005
- Last Update Date
- 09-15-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Acute Care Hospital Critical Access
- Taxonomy Code
- 282NC0060X
- Type
- Hospitals
- License No.
- 110000174
- License State
- CA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| HSP40539G | MEDICAID (05) | CA | |
| ZZZC1702Z | OTHER (01) | CA | BLUE SHIELD INPATIENT |
| ZZR00539G | MEDICAID (05) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0611927
- Facility Type
- Hospital
- Certificate Effective Date
- January 03, 2025
- Certificate Expiration Date
- January 02, 2027
- Laboratory Director
- ANTHONY E. VICTORIO
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Adventist Health Clearlake Hospital Inc. on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1124018031, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CLEARLAKE, CA 95422
CLEARLAKE, CA 95422
CLEARLAKE, CA 95422
CLEARLAKE, CA 95422
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124018031, enumerated as an "organization" on October 24, 2005.
The provider is located at 15630 18TH AVE CLEARLAKE, CA 95422 and the phone number is (707) 994-6486.
General Acute Care Hospital with taxonomy code 282NC0060X and a focus in Critical Access.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
