LA CLINICA DE LA RAZA, INC. (NPI# 1669773008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669773008 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE LA RAZA, INC. |
| Other Organization Name | CASA DEL SOL (ASCEND ELEMENTARY SCHOOL) |
| Practice Address |
3709 E 12th St Oakland CA 94601-4001 |
| Mailing Address |
Po Box 22210 Oakland CA 94623-2210 |
| Practice Telephone | 5105356200 |
| Practice Fax Number | 5105354167 |
| Mailing Telephone | 5105354000 |
| Mailing Fax Number | 5105354189 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-18 |
| Authorized Official Name | JANE GARCIA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5105354000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ACBHCS | TBD | 01 |
| Other Name | Type Code |
|---|---|
| Casa del Sol (Ascend Elementary School) | Other Name - Individual/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 |
| 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 |
| 1245671726 | La Clinica De La Raza, Inc. | Clinic/Center | 1390 66th Ave, Oakland, CA 94621-3506 | 2013-07-11 |
| 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 |
3709 E 12TH ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94601-4001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063845535 | Lee Butler | Counselor | 3709 E 12th St, Oakland, CA 94601-4001 | 2013-08-19 |
| 1992049266 | Allison Guilfoil | Counselor | 3709 E 12th St, Oakland, CA 94601-4001 | 2012-11-26 |
| 1457609661 | Seneca Family of Agencies | Community/Behavioral Health | 3709 E 12th St, Oakland, CA 94601-4001 | 2012-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750988762 | Mohini Gadre | Student in an Organized Health Care Education/Training Program | Casa Del Sol, 1501 Fruitvale Ave, Oakland, CA 94601 | 2020-10-02 |
| 1730704289 | Francheska Baloy | Student in an Organized Health Care Education/Training Program | 13585 San Pablo, San Pablo, CA 94601 | 2020-06-10 |
| 1104476597 | Jonathan Ramos Santiago | Social Worker | 13585 San Pablo, 1st Floor, San Pablo, CA 94601 | 2019-09-17 |
| 1205329802 | Stefany Menjivar | Student in an Organized Health Care Education/Training Program | 3908 International Blvd, Oakland, CA 94601 | 2018-06-08 |
| 1710408430 | Martha Alicia Rea | Physician Assistant | 3301 E. 12th St, Suite 113, Oakland, CA 94601 | 2017-07-03 |
| 1922528744 | Jamie Erin Briskin | Social Worker | 3001 International Blvd., Oakland, CA 94601 | 2017-06-22 |
| 1194254706 | Emily Lohmeyer | Student in an Organized Health Care Education/Training Program | 1501 Fruitvale Avenue, Oakland, CA 94601 | 2017-06-07 |
| 1124551494 | Emily Chana Wolfe-roubatis | Midwife | 1450 Fruitvale Ave Fl 3, Oakland, CA 94601 | 2017-04-04 |
| 1417327776 | Ninfa M. Gutierrez | Counselor | 3124 International Blvd., Oakland, CA 94601 | 2015-09-30 |
| 1942600424 | Reliable Care Express, Inc. | Non-emergency Medical Transport (VAN) | 828 27th Ave, Oakland, CA 94601 | 2014-09-03 |
| Find all providers in zip 94601 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619177300 | Children's Hospital & Research Center At Oakland | Clinic/Center | 770 53rd St, Oakland, CA 94609 | 2007-07-20 |
| 1306329842 | Tammy Lynette Cloud | Clinic/Center | 8711 Macarthur Blvd, Oakland, CA 94605-4000 | 2018-09-11 |
| 1285125906 | A Better Way, Inc | Clinic/Center | 1926 E 19th St, Oakland, CA 94606-4126 | 2018-05-29 |
| 1477961613 | La Clinica De La Raza, Inc. | Clinic/Center | 4610 Foothill Blvd, Oakland, CA 94601-4618 | 2014-07-31 |
| 1255691036 | Children's Hospital & Research Center At Oakland | Clinic/Center | 5275 Claremont Ave, Oakland, CA 94609 | 2012-05-25 |
| 1881954725 | Child Assessment and Transition Services (cats) | Clinic/Center | 5275 Claremont Ave, Oakland, CA 94618-1032 | 2012-05-25 |
| 1013105246 | The Alliance for Community Wellness | Clinic/Center | 3315 International Blvd, Oakland, CA 94601-3005 | 2007-10-12 |
| 1710177803 | Children's Hospital & Research Center At Oakland | Clinic/Center | 5275 Claremont Ave., Oakland, CA 94609 | 2007-07-26 |
| 1245430016 | Behavior Emergency Response Team | Clinic/Center | 747 52nd St, Oakland, CA 94609-1809 | 2007-07-20 |
| 1326247891 | Neuopsychology Department | Clinic/Center | 770 53rd Street, Oakland, CA 94609-1809 | 2007-07-16 |
| Find all providers in OAKLAND | ||||
Please comment or provide details below to improve the information on LA CLINICA DE LA RAZA, INC..
| 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.