SOUTH COUNTY COMMUNITY HEALTH CENTER INC (NPI# 1821170044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821170044 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY COMMUNITY HEALTH CENTER INC |
| Other Organization Name | RAVENSWOOD FAMILY HEALTH CENTER |
| Practice Address |
1885 Bay Road East Palo Alto CA 94303-1611 |
| Practice Telephone | 6503307400 |
| Practice Fax Number | 6503211560 |
| Mailing Telephone | 6503307400 |
| Mailing Fax Number | 6503211560 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-06-02 |
| Authorized Official Name | MR. ROGER WAYNE YOST (CFO) |
| Authorized Official Telephone | 6503307400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70935F | 05 | |
| CA | EAPC | EAP70935F | 01 |
| CA | FAMILY PACT | HAP70935F | 01 |
| CA | CANCER DETECTION PROGRAM | BCP70935F | 01 |
| Other Name | Type Code |
|---|---|
| Ravenswood Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055034 | South County Community Health Center Inc | Clinic/Center | 900 Miramonte Ave Fl 2, Mountain View, CA 94040-2457 | 2020-02-19 |
| 1730712613 | South County Community Health Center Inc | Clinic/Center | 785 Morse Ave, Sunnyvale, CA 94085-3010 | 2020-02-19 |
| 1861025736 | South County Community Health Center Inc | Clinic/Center | 270 Grant Ave, Palo Alto, CA 94306-1911 | 2020-02-19 |
| Street Address |
1885 BAY ROAD |
| City | EAST PALO ALTO |
| State | CA |
| Zip Code | 94303-1611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1932652013 | Tala Sailele | Counselor | 2560 Pulgas Ave., East Palo Alto, CA 94303 | 2016-07-26 |
| 1952784308 | Lakshmi Leishangthem | Psychiatry & Neurology | Byers Eye Institute Stanford Health Care 2452 Watson Ct, 2452 Watson Court, Palo Alto, CA 94303 | 2015-07-02 |
| 1083041636 | Malaika House | Substance Abuse Rehabilitation Facility | 819 & 823 Jamie Lane, East Palo Alto, CA 94303 | 2013-09-27 |
| 1184913246 | Naeem Hashmi Medical Corporation | Internal Medicine | 957 Colonial Lane, Palo Alto, CA 94303 | 2011-03-29 |
| 1346550902 | Elizabeth A. Herb, M.d., A Professional Corporation | Clinic/Center | 851 Southampton Dr., Palo Alto, CA 94303 | 2010-10-18 |
| 1083878367 | Achievekids | Health Maintenance Organization | 3860 Middlefield Road, Achievekids, Palo Alto, CA 94303 | 2008-07-15 |
| 1528192895 | Susann Elizabeth Amborn | Psychologist | 1020 Corporation Way, Suite 201, Palo Alto, CA 94303 | 2007-03-16 |
| 1356409882 | Steven Richard Sanislo | Ophthalmology | 2452 Watson Court, Palo Alto, CA 94303 | 2006-12-05 |
| Find all providers in zip 94303 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376697482 | South County Community Health Center Inc. | Clinic/Center | 1798 Bay Rd # A, East Palo Alto, CA 94303-1611 | 2007-01-23 |
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| City | EAST PALO ALTO |
| Zip Code | 94303 |
Please comment or provide details below to improve the information on SOUTH COUNTY COMMUNITY HEALTH CENTER 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.