LA CLINICA DE LA RAZA, INC. (NPI# 1851522015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851522015 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE LA RAZA, INC. |
| Other Organization Name | ROOSEVELT HEALTH CENTER |
| Practice Address |
1926 - 19th Avenue Oakland CA 94606-4126 |
| Mailing Address |
Po Box 22210 Oakland CA 94623-2210 |
| Practice Telephone | 5108792953 |
| Practice Fax Number | 5108792956 |
| Mailing Telephone | 5105354000 |
| Mailing Fax Number | 5105354189 |
| Enumeration Date | 2009-08-05 |
| 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 | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550000036 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1851522015 | 05 | |
| CA | FPACT | 1851522015 | 01 |
| Other Name | Type Code |
|---|---|
| Roosevelt 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 |
| 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 |
1926 - 19TH AVENUE |
| City | OAKLAND |
| State | CA |
| Zip Code | 94606-4126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366923369 | Rhummanee Hang | Case Manager/Care Coordinator | 544 International Blvd., Suite #9, Oakland, CA 94606 | 2018-08-27 |
| 1841746153 | First Aid Transportation LLC | Non-emergency Medical Transport (VAN) | 1709 International Blvd Ste 107, Oakland, CA 94606 | 2016-08-27 |
| 1609236686 | Erik D Grasso | Behavioral Analyst | 1340 East 28th St., Suite C, Oakland, CA 94606 | 2016-03-03 |
| 1457770935 | Jessica Robin Gar Ling Leung | Family Medicine | 250 E. 18th Street, 2nd Floor, Oakland, CA 94606 | 2014-04-10 |
| 1902230709 | Masja Van Der Hoog | Acupuncturist | 1511 23rd Ave, Apt 10, Oakland, CA 94606 | 2013-08-28 |
| 1063756997 | Christine Michelle Huffner | Nurse Practitioner | 1030 International Blvd. San Antonio Neighborhood Healt, Oakland, CA 94606 | 2012-11-15 |
| 1336418920 | Alexandra Elisabeth Brewster | Counselor | 907 Lake Street San Pablo Avenue, San Pablo, CA 94606 | 2011-12-28 |
| 1780964064 | Meagen Elizabeth Grundberg | Community Health Worker | 544 International Blvd Ste 9, Oakland, CA 94606 | 2011-08-18 |
| 1285764217 | Nguyen Tran Dang, Dds, Inc. | Dentist | 270 East 12th St., Oakland, CA 94606 | 2007-03-07 |
| 1689704017 | Nguyen Tran Dang | Dentist | 270 East 12th Street, Oakland, CA 94606 | 2007-03-06 |
| Find all providers in zip 94606 | ||||
| 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 | ||||
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.