SHINGLETOWN MEDICAL CENTER
NPI 1750387072
Clinic/Center - Federally Qualified Health Center (FQHC) in Shingletown, CA

Q: What is Shingletown Medical Center's NPI number?

The NPI number for Shingletown Medical Center is 1750387072. It was assigned to this organization in the NPPES registry on June 22, 2005.

Q: What is Shingletown Medical Center's specialty?

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

Active since June 22, 2005CLIA 05D0618500 · Microscopy

31292 ALPINE MEADOWS RD, SHINGLETOWN, CA 96088(530) 474-3390(530) 474-4899 Get Directions Write a Review

NPPES record last updated: June 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Shingletown Medical Center NPPES

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

SHINGLETOWN MEDICAL CENTER (NPI 1750387072) is a healthcare organization registered as a federally qualified health center (fqhc) in Shingletown, California and active in the NPI registry since June 2005. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Tami Fraser, Ceo, as its authorized official.

NPPES Registry Identity

NPI1750387072

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameSHINGLETOWN MEDICAL CENTER

Location Address31292 ALPINE MEADOWS RDShingletown, CA 96088-9462

Mailing Address31292 Alpine Meadows RdShingletown, CA 96088-9462 · (530) 474-3390 · Fax (530) 474-4899

Phone(530) 474-3390

Fax(530) 474-4899

Organization SubpartNo

Authorized OfficialTami FraserCeo · (530) 474-3390

Enumeration DateJune 22, 2005

Last NPPES UpdateJune 22, 2021

NPPES CertifiedJune 22, 2021

✔ NPI 1750387072 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

License✔ Licensed in CA · 230000091

31292 ALPINE MEADOWS RD, Shingletown, CA 96088

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Other Identifiers 2

MedicaidFHC03870FCA

OtherZZZ30035ZCA · Blue Shield

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) 05D0618500

Shingletown Medical Center · Shingletown, CA

Active · expires Aug 31, 2026

CLIA Number05D0618500

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorSteven Licata

Laboratory Phone(530) 474-3390

Laboratory LocationShingletown Medical Center31292 Alpine Meadows Road, Shingletown, CA 96088

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 11

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

DR. ALBERT GORDON LUI MD

Family Medicine