INDIAN HEALTH CENTER OF SANTA CLARA VALLEY (NPI# 1164643862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164643862 |
| Entity Type | Organization |
| Organization Name | INDIAN HEALTH CENTER OF SANTA CLARA VALLEY |
| Practice Address |
1333 Meridian Ave San Jose CA 95125-5212 |
| Practice Telephone | 4084453400 |
| Practice Fax Number | 4084481727 |
| Mailing Telephone | 4084453400 |
| Mailing Fax Number | 4084481727 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-06-10 |
| Authorized Official Name | DR. ALDON WAYNE SCOTT (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 4084453400 |
| Authorized Official Credential | D.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
070000118 | CA | Ambulatory Health Care Facilities |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
070000118 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DELTA DENTAL | G01133-01 | 01 |
| CA | FHC11833F | 05 | |
| CA | MEDICAL | FHC11833F | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1437607355 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 204b, San Jose, CA 95128-4815 | 2016-09-20 |
| 1629462312 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 105, San Jose, CA 95128-4815 | 2015-03-20 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1538529052 | Indian Health Center of Santa Clara Valley | Clinic/Center | 25 N 14th St Ste 140, San Jose, CA 95112-6218 | 2016-02-25 |
| 1326425265 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2030 Forest Ave Ste 110, San Jose, CA 95128-4833 | 2015-04-29 |
| 1114290780 | Indian Health Center of Santa Clara Valley | Clinic/Center | 455 Oconnor Dr Ste 200, San Jose, CA 95128-1632 | 2012-02-13 |
| 1366726903 | Indian Health Center of Santa Clara Valley | Clinic/Center | 602 E Santa Clara St, San Jose, CA 95112-1908 | 2011-09-30 |
| 1518240118 | Indian Health Center of Santa Clara Valley | Clinic/Center | 602 E Santa Clara St, Suite 230, San Jose, CA 95112-1908 | 2011-09-21 |
| 1881997963 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2010-12-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDIAN HEALTH CENTER OF SANTA CLARA VALLEY | 1333 Meridian Ave, San Jose, CA 95125-5212 |
| Street Address |
1333 MERIDIAN AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95125-5212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588621577 | Beahwa Yeoh | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2006-04-26 |
| 1346720109 | Pamela Gayle Ghareeb Gudino | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2018-08-20 |
| 1639681513 | Tammy S. Hwang | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2017-10-31 |
| 1255859872 | Vinh Buu Cai | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125 | 2017-09-04 |
| 1053841338 | Elle Dinh | Dentist | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2017-06-19 |
| 1952839110 | Christopher Solis | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2017-05-31 |
| 1225496946 | Hoaihuong Nguyen | Dentist | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2016-02-09 |
| 1598141384 | Prisila Gonzalez | Nurse Practitioner | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2015-08-04 |
| 1871992065 | Mala Gopal | Dentist | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2014-08-14 |
| 1265877948 | Saira Muhammed | Dentist | 1333 Meridian Ave, San Jose, CA 95125-5212 | 2013-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1376197848 | Mariam Samir Abadir | Dentist | 1670 Westwood Dr. Suite K, San Jose, CA 95125 | 2019-08-01 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1659809259 | Edward Escoto | Assistant Behavior Analyst | 2075 Lincoln Ave Ste D, San Jose, CA 95125 | 2017-05-25 |
| 1104288422 | Kristin Ann Dessau | Counselor | 1261 Lincoln Avenue, Suite 202, San Jose, CA 95125 | 2016-03-25 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1598042905 | Walgreens | Exclusive Provider Organization | 2585 Almaden Road, San Jose, CA 95125 | 2011-11-14 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1699093724 | Lokahi Acupuncture, Inc. | Acupuncturist | 1688 Willow Street, Suite B, San Jose, CA 95125 | 2010-05-13 |
| 1538482468 | Mark Lucius Yoslow | Psychologist | 970 Minnesota Avenue, San Jose, CA 95125 | 2010-03-06 |
| Find all providers in zip 95125 | ||||
| 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 |
|---|---|---|---|---|
| 1669094504 | Bay Area Community Health | Clinic/Center | 3434 Silver Creek Rd Rm M1, San Jose, CA 95121-1845 | 2020-05-14 |
| 1720600760 | Bay Area Community Health | Clinic/Center | 2880 Story Rd Ste 10, San Jose, CA 95127-3942 | 2020-05-13 |
| 1487276424 | Bay Area Community Health | Clinic/Center | 242 La Pala Dr Ste A&b, San Jose, CA 95127-2103 | 2020-05-13 |
| 1598387672 | Bay Area Community Health | Clinic/Center | 3200 Senter Rd Rm S104, San Jose, CA 95111-1332 | 2020-05-12 |
| 1962024059 | Bay Area Community Health | Clinic/Center | 1066 S White Rd Ste 170, San Jose, CA 95127-3812 | 2020-05-12 |
| 1407478597 | Bay Area Community Health | Clinic/Center | 1855 Lucretia Ave Bldg M, San Jose, CA 95122-3730 | 2020-05-12 |
| 1659993632 | Bay Area Community Health | Clinic/Center | 617 N Jackson Ave Bldg 1, San Jose, CA 95133-2345 | 2020-05-12 |
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1770027047 | San Jose Foothill Family Community Clinic, Inc. | Clinic/Center | 3434 Silver Creek Rd, Room M1, San Jose, CA 95121-1845 | 2016-12-06 |
| 1437607355 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 204b, San Jose, CA 95128-4815 | 2016-09-20 |
| Find all providers in SAN JOSE | ||||
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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.