Healthcare Provider Details

I. General information

NPI: 1992012306
Provider Name (Legal Business Name): ROLLING HILLS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 PEACH ST
CORNING CA
96021-3355
US

IV. Provider business mailing address

PO BOX 908
CORNING CA
96021-0908
US

V. Phone/Fax

Practice location:
  • Phone: 530-690-2827
  • Fax: 978-416-8198
Mailing address:
  • Phone: 530-690-2827
  • Fax: 530-690-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: JEANNETTE LEFDAL
Title or Position: REVENUE CYCLE DIRECTOR
Credential:
Phone: 530-900-7588