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COLUSA INDIAN HEALTH CLINIC
NPI 1144582925
Nurse Practitioner - Family in Colusa, CA

Active since June 08, 2012CLIA 05D0985302 · Waiver
3710 HIGHWAY 45, COLUSA, CA 95932(530) 458-5501(530) 458-8660 Get Directions Write a Review

NPPES record last updated: June 8, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Colusa Indian Health Clinic NPPES

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

COLUSA INDIAN HEALTH CLINIC (NPI 1144582925) is a healthcare organization registered as a family in Colusa, California and active in the NPI registry since June 2012. The organization holds a CLIA Waiver certificate valid through October 3, 2026 and lists Mark Sprague, Director Of Clinic Operations, as its authorized official.

NPPES Registry Identity

NPI1144582925
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCOLUSA INDIAN HEALTH CLINIC
Location Address3710 HIGHWAY 45Colusa, CA 95932-4026
Mailing Address3710 Highway 45Colusa, CA 95932-4026 · (530) 458-5501 · Fax (530) 458-8660
Phone(530) 458-5501
Fax(530) 458-8660
Organization SubpartYesParent: Colusa Indian Community Council
Authorized OfficialMark SpragueDirector Of Clinic Operations · (530) 458-5501
Enumeration DateJune 8, 2012
✔ NPI 1144582925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 021859
3710 HIGHWAY 45, Colusa, CA 95932
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 of Waiver 05D0985302

Colusa Indian Health Clinic · Colusa, CA
Active · expires Oct 3, 2026
CLIA Number05D0985302
Laboratory TypeTribal Health Clinic
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateOctober 3, 2026
Laboratory DirectorHarpreet Johl
Laboratory Phone(530) 458-5501
Laboratory LocationColusa Indian Health Clinic3710 Hwy 45, Colusa, CA 95932
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

COLUSA INDIAN COMMUNITY COUNCIL
Clinic/Center (Federally Qualified Health Center (FQHC))
3710 HIGHWAY 45
COLUSA, CA 95932
Colusa County (530) 458-5501
COLUSA INDIAN COMMUNITY COUNCIL
Clinic/Center (Federally Qualified Health Center (FQHC))
3710 HIGHWAY 45
COLUSA, CA 95932
Colusa County (530) 458-5501
MATHEW GREGORY FONTES MA
Marriage & Family Therapist
3710 HIGHWAY 45
COLUSA, CA 95932
Colusa County (530) 458-5501

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 Colusa Indian Health Clinic's NPI number?

The NPI number for Colusa Indian Health Clinic is 1144582925. It was assigned to this organization in the NPPES registry on June 8, 2012.

Where is Colusa Indian Health Clinic located?

Colusa Indian Health Clinic is located at 3710 Highway 45, Colusa, CA 95932. The listed phone number is (530) 458-5501.

What is Colusa Indian Health Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Colusa Indian Health Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0985302) is associated with this NPI, valid through October 3, 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 Colusa Indian Health Clinic was last updated on June 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.