Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Northeastern Rural Health Clinics

Organization Family Medicine Physician · NPI 1477563518

Northeastern Rural Health Clinics provides Family Medicine Physician services in Susanville, California. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

1850 Spring Ridge Dr
Susanville, CA 96130-6100
Phone: (530) 251-5000
Fax: (530) 252-1340
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1477563518
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationNortheastern Health Center
Authorized official Lacey Lively — Ceo · (530) 251-5000
NPI enumeratedAugust 9, 2006
Last updated in NPPESSeptember 10, 2025
Certification dateSeptember 10, 2025
Mailing address1850 Spring Ridge Dr, Susanville, CA 96130-6100

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