LA CLINICA DE LA RAZA, INC.


Address: 220 Hospital Dr, Vallejo, CA 94589-2517
Phone: 7076411900

LA CLINICA DE LA RAZA, INC. (NPI# 1720243454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720243454
Entity Type Organization
Organization Name LA CLINICA DE LA RAZA, INC.
Other Organization Name LA CLINICA NORTH VALLEJO
Practice Address 220 Hospital Dr
Vallejo
CA 94589-2517
Mailing Address Po Box 22210
Oakland
CA 94623-2210
Practice Telephone 7076411900
Practice Fax Number 7075542294
Mailing Telephone 5105354000
Mailing Fax Number 5105354189
Enumeration Date 2008-07-22
Last Update Date 2019-10-17
Authorized Official Name MS. JANE GARCIA (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 5105352915
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 291U00000X Clinical Medical Laboratory 05D1087668 CA Laboratories
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
110000270 CA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA 1720243454 05

Other Provider/Organization Names

Other Name Type Code
La Clinica North Vallejo Doing Business As Name - Organization

Other Provider IDs and Locations

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
1851522015 La Clinica De La Raza, Inc. Clinic/Center 1926 - 19th Avenue, Oakland, CA 94606-4126 2009-08-05
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

Other Data Sources

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

Office Location

Street Address 220 HOSPITAL DR
City VALLEJO
State CA
Zip Code 94589-2517

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427612910 Heather Wright Physician Assistant 220 Hospital Dr, Vallejo, CA 94589-2517 2019-04-30
1235515511 La Clinica De La Raza Clinic/Center 220 Hospital Dr, Vallejo, CA 94589-2517 2015-08-10
1598083164 Hakeem O. Adeniyi Jr. Family Medicine 220 Hospital Dr, Vallejo, CA 94589-2517 2010-05-06
1962737460 Marites Less Nurse Practitioner 220 Hospital Dr, Vallejo, CA 94589-2517 2009-10-16
1245462209 Sarah Catherine Quesnell Social Worker 220 Hospital Dr, Vallejo, CA 94589-2517 2009-08-10
1538241401 Aide Irene Paredes-salceda Physician Assistant 220 Hospital Dr, Vallejo, CA 94589-2517 2006-10-20
1811098007 Ruth Etta Shelton-pryor Family Medicine 220 Hospital Dr, Vallejo, CA 94589-2517 2006-09-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366903478 Nabreea Dianna Moore Behavioral Analyst 1300 Donner Pass Rd, Vallejo, CA 94589 2019-03-29
1588131221 Alejandra Hernandez De Leon Behavioral Analyst 151 Mimosa Ct, Vallejo, CA 94589 2018-10-31
1821588948 Angela Ancheta Laco Behavioral Analyst 71 Los Cerritos Dr, Vallejo, CA 94589 2018-05-14
1851750764 Shauntell Hudson Counselor 112 Basalt Dr, Vallejo, CA 94589 2016-02-19
1982997680 Shuttle California Transit, LLC Private Vehicle 322 Lemon St, Vallejo, CA 94589 2011-05-27
1588813455 Shay Teresa Loftus Psychologist 1761 Broadway, Suite 100, Vallejo, CA 94589 2008-09-16
1063629236 Michael Francis Edziak Dentist 150 Hospital Dr., Vallejo, CA 94589 2007-05-17
1346454220 Diljit Bahuleyan Karayil Internal Medicine 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 2007-05-09
1174745525 Thomas Welch Gross Emergency Medicine Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 2007-05-03
1639207756 James D Prigmore Dentist 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 2007-03-01
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Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962739946 La Clinica De La Raza, Inc. Clinic/Center 220 Hospital Drive, Vallejo, CA 94589-2517 2009-11-11
1598986010 County of Solano Clinic/Center 355 Tuolumne St, Vallejo, CA 94590-5700 2007-05-01

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1508464116 Golden Valley Health Center Clinic/Center 1524 Mchenry Ave Ste 560, Modesto, CA 95350-4573 2020-10-15
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Competitor

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City VALLEJO
Zip Code 94589

Improve Information

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Dataset Information

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.

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