LA CLINICA DE LA RAZA INC (NPI# 1346262292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346262292 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DE LA RAZA INC |
| Other Organization Name | LA CLINICA DENTAL AT CHILDREN'S HOSPITAL OAKLAND |
| Practice Address |
4881 Telegraph Ave Oakland CA 94609-2009 |
| Mailing Address |
Po Box 22210 Oakland CA 94623-2210 |
| Practice Telephone | 5104283316 |
| Practice Fax Number | 5104505806 |
| Mailing Telephone | 5105354000 |
| Mailing Fax Number | 5105354189 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2019-02-06 |
| 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 | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
140000670 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC71017F | 05 |
| Other Name | Type Code |
|---|---|
| La Clinica Dental at Children's Hospital Oakland | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992863096 | La Clinica De La Raza Inc | Clinic/Center | 210 Hospital Dr, Vallejo, CA 94589-2517 | 2006-12-04 |
| 1326154360 | La Clinica De La Raza Inc | Clinic/Center | 3050 E 16th St, Oakland, CA 94601-2319 | 2006-08-22 |
| 1144336181 | La Clinica De La Raza Inc | Clinical Medical Laboratory | 3451 E 12th St, Oakland, CA 94601-3425 | 2006-08-22 |
| 1124035159 | La Clinica De La Raza Inc | Optometrist | 3060b E 9th St, Oakland, CA 94601-2322 | 2006-08-02 |
| 1538181482 | La Clinica De La Raza Inc | Clinic/Center | 2000 Sierra Road, Concord, CA 94518-2905 | 2006-07-23 |
| 1780606632 | La Clinica De La Raza Inc | Clinic/Center | 2920a Sonoma Blvd, Vallejo, CA 94590-3879 | 2006-07-23 |
| 1013085778 | La Clinica De La Raza Inc | Clinic/Center | 4351 Broadway, Oakland, CA 94611-4612 | 2006-12-01 |
| 1619056926 | La Clinica De La Raza Inc | Clinic/Center | 4610 Foothill Blvd, Oakland, CA 94601-4618 | 2006-11-06 |
| 1174639116 | La Clinica De La Raza Inc | Clinic/Center | 1501 Fruitvale Ave, Oakland, CA 94601-2322 | 2006-08-22 |
| 1235245275 | La Clinica De La Raza Inc | Clinical Medical Laboratory | 1515 Fruitvale Ave, Oakland, CA 94601-2322 | 2006-08-22 |
| Street Address |
4881 TELEGRAPH AVE |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205250081 | Michael Suh | Dentist | 4881 Telegraph Ave, Oakland, CA 94609-2009 | 2014-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| 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 | ||||
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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.