LA CLINICA DE LA RAZA, INC. (NPI# 1245671726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245671726 |
Entity Type | Organization |
Organization Name | LA CLINICA DE LA RAZA, INC. |
Other Organization Name | HAVENSCOURT HEALTH CENTER |
Practice Address |
1390 66th Ave Oakland CA 94621-3506 |
Mailing Address |
Po Box 22210 Oakland CA 94623-2210 |
Practice Telephone | 5106391981 |
Practice Fax Number | 5106328225 |
Mailing Telephone | 5105354000 |
Mailing Fax Number | 5105354189 |
Enumeration Date | 2013-07-11 |
Last Update Date | 2019-10-17 |
Authorized Official Name | MS. JANE GARCIA (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 5105354000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
N | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities | ||
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1245671726 | 05 |
Other Name | Type Code |
---|---|
Havenscourt Health Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982118675 | La Clinica De La Raza, Inc. | Clinic/Center | 2005c Main St, Oakley, CA 94561-3301 | 2017-11-17 |
1669773008 | La Clinica De La Raza, Inc. | Clinic/Center | 3709 E 12th St, Oakland, CA 94601-4001 | 2010-11-16 |
1629379896 | La Clinica De La Raza, Inc. | Clinic/Center | 1415-1423 Fruitvale Ave, Oakland, CA 94601-2320 | 2010-11-04 |
1851522015 | La Clinica De La Raza, Inc. | Clinic/Center | 1926 - 19th Avenue, Oakland, CA 94606-4126 | 2009-08-05 |
1184194482 | La Clinica De La Raza, Inc. | Pharmacy | 3451 E 12th St, Oakland, CA 94601-3463 | 2018-11-29 |
1477961613 | La Clinica De La Raza, Inc. | Clinic/Center | 4610 Foothill Blvd, Oakland, CA 94601-4618 | 2014-07-31 |
1770902314 | La Clinica De La Raza, Inc. | Clinic/Center | 1450 Fruitvale Ave, 3rd Floor, Oakland, CA 94601-2313 | 2014-04-10 |
1023445780 | La Clinica De La Raza, Inc. | Clinic/Center | 1700 28th Ave, Oakland, CA 94601-2455 | 2013-09-26 |
1578834164 | La Clinica De La Raza, Inc. | Clinical Medical Laboratory | 2021 Main St, Oakley, CA 94561-3302 | 2012-01-13 |
1730476110 | La Clinica De La Raza, Inc. | Pharmacy | 1030 International Blvd, Oakland, CA 94606-3730 | 2011-07-06 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | LA CLINICA DE LA RAZA, INC. | 1515 Fruitvale Ave, Oakland, CA 94601-2322 |
Street Address |
1390 66TH AVE |
City | OAKLAND |
State | CA |
Zip Code | 94621-3506 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144378902 | Karen L Gersten-rothenberg | Nurse Practitioner | 1390 66th Ave, Oakland, CA 94621-3506 | 2007-01-08 |
1417403387 | Marisol Enos | Social Worker | 1390 66th Ave, Oakland, CA 94621-3506 | 2016-08-30 |
1508233198 | Erich Samuel Roberts | Social Worker | 1390 66th Ave, Oakland, CA 94621-3506 | 2015-08-31 |
1093117590 | Amber Nutter | Social Worker | 1390 66th Ave, Oakland, CA 94621-3506 | 2014-09-16 |
1467889162 | East Bay Agency for Children | Community/Behavioral Health | 1390 66th Ave, Roots, Oakland, CA 94621-3506 | 2013-09-26 |
1811332091 | Sarah Taylor | Social Worker | 1390 66th Ave, Oakland, CA 94621-4107 | 2013-05-01 |
1538418033 | Alliant International University | Community/Behavioral Health | 1390 66th Ave, Oakland, CA 94621-3506 | 2012-08-30 |
1689944365 | Oakland Unified School District | Local Education Agency (LEA) | 1390 66th Ave, Oakland, CA 94621-3506 | 2012-01-11 |
1740508266 | Barbara Ruth Campbell | Social Worker | 1390 66th Ave, Oakland, CA 94621-3506 | 2010-05-07 |
1841452935 | Arin L Kramer | Registered Nurse | 1390 66th Ave, Oakland, CA 94621-3506 | 2008-06-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144734864 | Alameda Home Care & Hospice LLC | Home Health | 300 Pendleton Way Ste 328, Oakland, CA 94621 | 2017-11-17 |
1760931968 | Maria Martinez | Counselor | 8330 Birch St., Apt. A, Oakland, CA 94621 | 2016-09-28 |
1902231301 | East Bay Agencey for Children | Community/Behavioral Health | 1025 81st Ave, Oakland, CA 94621 | 2013-09-05 |
1710268016 | Srideep Chatterjee | Pharmacist | 8102 E 14 Th Street, Oakland, CA 94621 | 2011-08-31 |
1285953943 | Martin Pacheco | Counselor | 333 Hegenberger Road #600, Oakland, CA 94621 | 2010-05-20 |
1821234816 | Raul Mark Miranda Grageda | Physical Therapist | 7817 Oakport Street, Oakland, CA 94621 | 2008-12-23 |
1306032156 | Adrienne Claire Lopez Tiley | Counselor | 401 Roland Way Suite 100, Oakland, CA 94621 | 2007-09-14 |
1609067610 | Sandra Gaspar | Marriage & Family Therapist | 410 Roland Way. Suite 100, Oakland, CA 94621 | 2007-08-05 |
1053512608 | Ellis W. Jones | Counselor | 7501 International Blvd., Oakland, CA 94621 | 2007-05-30 |
1851507016 | Keith Reese | Social Worker | 1933-57 Th Avenue, Oakland, CA 94621 | 2007-05-15 |
Find all providers in zip 94621 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821501792 | Asian Health Services | Clinic/Center | 190 11th St, Oakland, CA 94607-4878 | 2017-11-14 |
1407109986 | County of Alameda Health Care Services Agency | Clinic/Center | 384 14th St, Oakland, CA 94612-3211 | 2012-10-20 |
1073827242 | Asian Health Services | Clinic/Center | 817 Harrison Street, Oakland, CA 94607-4422 | 2010-07-30 |
1104959089 | Alameda Health System | Clinic/Center | 6955 Foothill Blvd Suite 200, Oakland, CA 94605-2409 | 2007-03-13 |
1679522627 | The West Oakland Health Council | Clinic/Center | 700 Adeline St, Oakland, CA 94607-2608 | 2006-05-08 |
1003340738 | Roosevelt School-based Behavioral Health | Clinic/Center | 1926 E 19th St, Oakland, CA 94606-4126 | 2017-04-19 |
1386096691 | Asian Health Services | Clinic/Center | 310 8th St Ste 210, Oakland, CA 94607 | 2016-07-11 |
1770902314 | La Clinica De La Raza, Inc. | Clinic/Center | 1450 Fruitvale Ave, 3rd Floor, Oakland, CA 94601-2313 | 2014-04-10 |
1831443563 | Lifelong Medical Care - Eastmont | Clinic/Center | 7200 Bancroft Ave, Suite 125a, Oakland, CA 94605-2403 | 2012-11-02 |
1467718148 | Asian Health Services | Clinic/Center | 275 14th St, Oakland, CA 94612-4070 | 2012-04-06 |
Find all providers in OAKLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.