La Clinica De La Raza INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Vallejo, CA. Organization (NPI-2).
NPI number1992863096
StatusActive
Last updated in NPPESOct 17, 2019
Details
- NPI
- 1992863096
- Entity type
- Organization (NPI-2)
- Legal business name
- La Clinica De La Raza INC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2006
- Last updated
- Oct 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | 550000257 | CA | Yes |
| 261QF0050X | Clinic/Center, Family Planning, Non-Surgical | – | – | |
| 291U00000X | Clinical Medical Laboratory | 05D1057049 | CA |
Other names
- La Clinica Vallejo Great Beginnings (Doing Business As)
Practice location
210 Hospital DrVallejo, CA 94589-2517
Phone 707-645-7316 · Fax 707-645-0426
Mailing address
Po Box 22210Oakland, CA 94623-2210
Phone 510-535-4000 · Fax 510-535-4189
Authorized official
Jane Garcia
Chief Executive Officer
5105352915
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All 6 Federally Qualified Health Center (FQHC) providers in Vallejo · All 3,369 providers in Vallejo
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