LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC. (NPI# 1184237489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184237489 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC. |
| Practice Address |
1011 La Loma Dr Medford OR 97504-8613 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5417791766 |
| Practice Fax Number | 5415122082 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| Authorized Official Name | TRACI FOSSEN (CHIEF QUALITY OFFICER) |
| Authorized Official Telephone | 5415123912 |
| Is Organization Subpart | Y |
| Parent Organization Name | LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| School Based Health Center- Orchard Hill Elementary School | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540398 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 102 Christian Avenue, Talent, OR 97540 | 2020-08-28 |
| 1790398048 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 307 Wagner Creek Road, Talent, OR 97540 | 2020-08-26 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1245860048 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 910 S Central Ave, Medford, OR 97501-7822 | 2020-01-21 |
| 1942793583 | La Clinica Del Valle Family Healthcare Center Inc. | Internal Medicine | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2018-06-08 |
| 1134302250 | La Clinica Del Valle Family Healthcare Center Inc. | Counselor | 1307 W Main St, Medford, OR 97501-2936 | 2007-12-12 |
| Street Address |
1011 LA LOMA DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154781508 | Carol Adams | Social Worker | 1011 La Loma Dr, Medford, OR 97504-8613 | 2016-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| 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 |
|---|---|---|---|---|
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1497090971 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 713 Summit Avenue, Medford, OR 97501 | 2012-12-10 |
| 1073511721 | Rogue Community Health | Clinic/Center | 19 Myrtle Street, Medford, OR 97504-7337 | 2005-07-07 |
| 1275132466 | Rogue Community Health | Clinic/Center | 1000 E Main St, Medford, OR 97504-7667 | 2020-10-20 |
| 1578090221 | Rch Hep C Program | Clinic/Center | 900 E Main St, Medford, OR 97504-7136 | 2017-05-12 |
| 1548792245 | Rogue Community Health | Clinic/Center | 19 Myrtle St, Medford, OR 97504-7337 | 2017-03-31 |
| 1093266983 | Rogue Community Health | Clinic/Center | 906 Royal Ct, Medford, OR 97504-6139 | 2016-10-17 |
| 1023561560 | Rogue Community Health | Clinic/Center | 900 E Main St, Medford, OR 97504-7136 | 2016-08-02 |
| 1669848792 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 730 Biddle Rd, Medford, OR 97504 | 2015-08-12 |
| 1417372731 | La Clinica Del Valle Family Health Care Center Inc | Clinic/Center | 910 S Central Ave, Medford, OR 97501-7822 | 2014-02-24 |
| Find all providers in MEDFORD | ||||
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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.