TH
Medical Clinic
TRIBAL HEALTH PEDIATRICS
359 LAKEPORT BOULEVARD, LAKEPORT, CA 95453
Source updated 2026-10-16. Source-listed location, not a NursingHomes.io endorsement. Confirm operating status, care availability, and services directly.
Official provider information
- CCN
- Not reported
- LTC
- NON-LTC
- NPI
- Not reported
- ZIP
- 95453
- id
- 6302
- CITY
- LAKEPORT
- FLAG
- Not reported
- ZIP9
- Not reported
- rank
- 0.057308756
- AO CD
- Not reported
- FACID
- 630015870
- DEEMED
- 0
- T18 19
- Not reported
- ADDRESS
- 359 LAKEPORT BOULEVARD
- AO NAME
- Not reported
- FACNAME
- TRIBAL HEALTH PEDIATRICS
- FAC FDR
- PRIMARY CARE CLINIC
- HCAI ID
- 306174015
- CAPACITY
- 0
- LATITUDE
- 39.03456226
- LOCATION
- (-122.9181729,39.034562261)
- DATA DATE
- 2026-10-16T00:00:00
- ISFACMAIN
- Y
- LONGITUDE
- -122.9181729
- CCLHO CODE
- 17
- CCLHO NAME
- LAKE
- START DATE
- Not reported
- TRAUMA CTR
- Not reported
- ASPEN FACID
- 630015870
- COUNTY CODE
- 160
- COUNTY NAME
- LAKE
- TERMINAT SW
- Y
- AO TRMNTN DT
- Not reported
- DMG EFCTV DT
- Not reported
- PARENT FACID
- Not reported
- TYPE OF CARE
- Not reported
- APPROVAL DATE
- Not reported
- BUSINESS NAME
- LAKE COUNTY TRIBAL HEALTH CONSORTIUM, INC.
- DISTRICT NAME
- SANTA ROSA
- FAC TYPE CODE
- COMTYC
- LICENSE NUMBER
- 550003047
- TRAUMA PED CTR
- Not reported
- DISTRICT NUMBER
- 11
- FIPS COUNTY CODE
- 6033
- LICENSED CERTIFIED
- LICENSED ONLY
- PARTICIPATION DATE
- Not reported
- CONTACT PHONE NUMBER
- (707) 263-8382
- FAC STATUS TYPE CODE
- OPEN
- INITIAL LICENSE DATE
- 2015-04-23T00:00:00
- BIRTHING FACILITY FLAG
- Not reported
- CAN BE DEEMED FAC TYPE
- N
- LICENSE EFFECTIVE DATE
- 2026-04-23T00:00:00
- ENTITY TYPE DESCRIPTION
- NONPROFIT CORP
- LICENSE EXPIRATION DATE
- 2027-04-22T00:00:00
- CRITICAl ACCESS HOSPITAL
- Not reported
- CAN BE CERTIFIED FAC TYPE
- Y
- LICENSE STATUS DESCRIPTION
- ACTIVE
- FAC FAC RELATIONSHIP TYPE CODE
- PARENT
COMMUNITY EXPERIENCE
Reviews of TRIBAL HEALTH PEDIATRICS
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