GARDNER FAMILY HEALTH NETWORK INC (NPI# 1376109629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376109629 |
| Entity Type | Organization |
| Organization Name | GARDNER FAMILY HEALTH NETWORK INC |
| Practice Address |
614 Tully Rd San Jose CA 95111-1048 |
| Mailing Address |
160 E Virginia St Ste 100 San Jose CA 95112-5865 |
| Practice Telephone | 4089771591 |
| Practice Fax Number | 4089981535 |
| Mailing Telephone | 4085796178 |
| Mailing Fax Number | 4085796143 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |
| Authorized Official Name | CHRISTINA CORNELL (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 4085796178 |
| Is Organization Subpart | Y |
| Parent Organization Name | GARDNER FAMILY HEALTH NETWORK INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Proyecto Primavera | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699041566 | Gardner Family Health Network Inc | Clinic/Center | 725 E. Santa Clara Street, San Jose, CA 95112-1900 | 2012-03-26 |
| 1164552931 | Gardner Family Health Network Inc | Clinic/Center | 1621 Gold St., Alviso, CA 95002-1240 | 2007-03-07 |
| 1083654545 | Gardner Family Health Network Inc | Clinic/Center | 1621 Gold Street, Alviso, CA 95002-1240 | 2006-06-06 |
| 1306309885 | Gardner Family Health Network Inc | Clinic/Center | 195 E San Fernando St, San Jose, CA 95112-3503 | 2019-04-10 |
| 1922366186 | Gardner Family Health Network Inc | Clinic/Center | 3351 El Camino Real, Suite 100, Atherton, CA 94027-3811 | 2012-04-25 |
| 1821239112 | Gardner Family Health Network Inc | Pharmacy | 7526 Monterey St, Gilroy, CA 95020-5826 | 2009-03-16 |
| 1558491043 | Gardner Family Health Network Inc | Clinic/Center | 3030 Alum Rock Ave, San Jose, CA 95127-2807 | 2007-03-06 |
| 1700915097 | Gardner Family Health Network Inc | Clinic/Center | 55 E Julian St, San Jose, CA 95112-4007 | 2007-03-05 |
| 1407985534 | Gardner Family Health Network Inc | Clinic/Center | 195 E Virginia St, San Jose, CA 95112-5844 | 2007-03-05 |
| 1144358748 | Gardner Family Health Network Inc | Clinic/Center | 7526 Monterey St, Gilroy, CA 95020-5826 | 2007-03-02 |
| Street Address |
614 TULLY RD |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95111-1048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699843060 | Minh Chau Duong | Counselor | 614 Tully Rd, San Jose, CA 95111-1048 | 2006-12-01 |
| 1629630421 | Sonia Clemente | Counselor | 614 Tully Rd, San Jose, CA 95111-1048 | 2019-07-01 |
| 1316406481 | Ngoc Nguyen Hong Pham | Social Worker | 614 Tully Rd, San Jose, CA 95111-1048 | 2019-03-18 |
| 1386114437 | Eloisa Ivette Rodriguez | Social Worker | 614 Tully Rd, San Jose, CA 95111-1048 | 2018-12-03 |
| 1275016669 | Carolina Garcia | Rehabilitation Counselor | 614 Tully Rd, San Jose, CA 95111-1048 | 2018-09-11 |
| 1326572959 | Mar Joseph Odias | Registered Nurse | 614 Tully Rd, San Jose, CA 95111-1048 | 2017-04-20 |
| 1770021206 | Ryan Pagala | Registered Nurse | 614 Tully Rd, San Jose, CA 95111-1048 | 2017-02-03 |
| 1134667652 | Veronica Pham | Registered Nurse | 614 Tully Rd, San Jose, CA 95111-1048 | 2017-02-03 |
| 1952849481 | Michael Borromeo | Registered Nurse | 614 Tully Rd, San Jose, CA 95111-1048 | 2017-02-03 |
| 1285176222 | Jagjit Kaur Sandher | Registered Nurse | 614 Tully Rd, San Jose, CA 95111-1048 | 2016-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134667413 | Aldo Hernandez | Community Health Worker | 488 Skyway Dr, San Jose, CA 95111 | 2017-02-07 |
| 1518217017 | Jean Jennifer J Soliven | Registered Nurse | 614 Tully Rd., San Jose, CA 95111 | 2012-09-12 |
| 1679894604 | Julie Chi | Counselor | 581 Coyote Road, San Jose, CA 95111 | 2010-06-14 |
| 1720278179 | Mv Transportation | Non-emergency Medical Transport (VAN) | 555 Tully Road, Mv Transportation, San Jose, CA 95111 | 2007-07-31 |
| 1437355948 | Anthony Cozzolino | Psychiatry & Neurology | 614 Tully Road, Narvaez Mental Health, San Jose, CA 95111 | 2007-06-22 |
| 1750403515 | Karen Pham | Dentist | 4074 Monterey Road, San Jose, CA 95111 | 2007-04-04 |
| 1376697847 | Mai Anh Le | Dentist | 60 Senter Rd, San Jose, CA 95111 | 2007-01-22 |
| 1649335852 | Bui and Enriquez Dental Corporation | Dentist | 485 Lewis Rd, Suite A, San Jose, CA 95111 | 2006-12-27 |
| 1619031903 | Huyen Thu Nguyen | Pharmacist | 796 Apple Terrace, San Jose, CA 95111 | 2006-12-20 |
| 1285720342 | Lily Khanh-linh Thi Nguyen | Obstetrics & Gynecology | 500 W Tully Rd, Ob/gyn Clinic, San Jose, CA 95111 | 2006-10-05 |
| Find all providers in zip 95111 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447718838 | Alum Rock Counseling Center | Community/Behavioral Health | 234 E Gish Rd Ste 200, San Jose, CA 95112-4724 | 2019-03-05 |
| 1184189722 | Uplift Family Services | Community/Behavioral Health | 653 Sylvandale Ave, San Jose, CA 95111-1414 | 2019-02-07 |
| 1386126621 | Alum Rock Counseling Center | Community/Behavioral Health | 14281 Story Road, San Jose, CA 95127 | 2018-09-04 |
| 1194218149 | Catholic Charities of Santa Clara County | Community/Behavioral Health | 2150 Alum Rock Ave, San Jose, CA 95116-2054 | 2018-06-13 |
| 1306336102 | Unity Care Group, Inc. | Community/Behavioral Health | 469 Delridge Dr, San Jose, CA 95111-1703 | 2018-05-16 |
| 1295230969 | Caminar | Community/Behavioral Health | 2202 N 1st St Ste 2210, San Jose, CA 95131-2007 | 2018-03-26 |
| 1487175485 | Arise Services | Community/Behavioral Health | 1009 E Capitol Expy # 407, San Jose, CA 95121-2415 | 2017-06-29 |
| 1811438765 | Family and Children Services A Division of Caminar | Community/Behavioral Health | 109 E Gish Rd, San Jose, CA 95112-4702 | 2017-03-12 |
| 1073052734 | County of Santa Clara | Community/Behavioral Health | 4825 Speak Ln, San Jose, CA 95118-3769 | 2017-02-14 |
| 1164965034 | Alum Rock Counseling Center, Inc. | Community/Behavioral Health | 1944 Flint Ave, San Jose, CA 95148-1213 | 2016-11-28 |
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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.