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DIGNITY HEALTH LASSEN MEDICAL CLINIC-COTTONWOOD
NPI 1235672403
Clinic/Center - Rural Health in Cottonwood, CA

Active since November 21, 2016CLIA Certified · 2 labs
20833 LONG BRANCH DR, COTTONWOOD, CA 96022(530) 347-3418(530) 528-4423 Get Directions Write a Review

NPPES record last updated: January 5, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 5, 2017, Nov 21, 2016 (2 updates tracked since 2016).

About Dignity Health Lassen Medical Clinic-cottonwood NPPES

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

DIGNITY HEALTH LASSEN MEDICAL CLINIC-COTTONWOOD (NPI 1235672403) is a healthcare organization registered as a rural health in Cottonwood, California and active in the NPI registry since November 2016. The organization holds 2 active CLIA laboratory certificates and lists Kim Miranda, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1235672403
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameDIGNITY HEALTH
Location Address20833 LONG BRANCH DRCottonwood, CA 96022-8701
Mailing Address2450 Sister Mary Columba DrRed Bluff, CA 96080-4356 · (530) 527-0414 · Fax (530) 528-4423
Phone(530) 347-3418
Fax(530) 528-4423
Organization SubpartYes
Authorized OfficialKim MirandaChief Financial Officer · (530) 225-6121
Enumeration DateNovember 21, 2016
Last NPPES UpdateJanuary 5, 20172 updates tracked since enumeration
✔ NPI 1235672403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
20833 LONG BRANCH DR, Cottonwood, CA 96022
Open in Google Maps ↗

Other Names 1

Doing Business AsDignity Health Lassen Medical Clinic-cottonwood

CLIA Laboratory Certificates CMS CLIA 2

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 Compliance 05D0618474

Dignity Health Lassen Medical Clinic Red Bluff · Red Bluff, CA
Active · expires Dec 8, 2027
CLIA Number05D0618474
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorTikoes Blankenberg
Laboratory Phone(530) 527-0414
Laboratory LocationDignity Health Lassen Medical Clinic Red Bluff2450 Sister Mary Columba Dr, Red Bluff, CA 96080
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 05D0618340

Dignity Health Lassen Medical Clinic Cottonwood · Cottonwood, CA
Active · expires Apr 11, 2028
CLIA Number05D0618340
Laboratory TypeRural Health Clinic
Certificate Effective DateApril 12, 2026
Certificate Expiration DateApril 11, 2028
Laboratory DirectorTikoes A. Blankenberg
Laboratory Phone(530) 529-8217
Laboratory LocationDignity Health Lassen Medical Clinic Cottonwood20833 Long Branch Dr, Cottonwood, CA 96022
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

MS. LENA BHARAT JESRANI MSN, FNP-BC
Nurse Practitioner (Family)
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 527-0414
DONNA HOLSCHER
Family Medicine
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 347-3418
MRS. NICOLE MARIE ILES FNP
Nurse Practitioner (Family)
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 347-3418
DR. ROMEO ARCEGA ABAYA JR. M.D.
Family Medicine
20833 LONG BRANCH DR, LASSEN MEDICAL GROUP INC
COTTONWOOD, CA 96022
Shasta County (530) 347-3418
LINETTE CRISTINE CALVO MD
Emergency Medicine
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 527-0414
LASSEN MEDICAL GROUP INC
Family Medicine
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 347-3418
HELEN YONGAO WILLIAMS FNP
Nurse Practitioner (Family)
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 527-0414
PATRICIA DE FREITAS SIMPLICIO ANANIAS
Family Medicine
20833 LONG BRANCH DR
COTTONWOOD, CA 96022
Shasta County (530) 347-3418

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 Dignity Health's NPI number?

The NPI number for Dignity Health is 1235672403. It was assigned to this organization in the NPPES registry on November 21, 2016. The provider is doing business as Dignity Health Lassen Medical Clinic-Cottonwood.

Where is Dignity Health located?

Dignity Health is located at 20833 Long Branch Dr, Cottonwood, CA 96022. The listed phone number is (530) 347-3418.

What is Dignity Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Dignity Health hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Dignity Health was last updated on January 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.