LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. (NPI# 1821333402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821333402 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. |
| Other Organization Name | LA CLINICA SCHOOL-BASED HEALTH CENTER AT PHOENIX ELEMENTARY SCHOOL |
| Practice Address |
215 N Rose St Phoenix OR 97535 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5415351065 |
| Practice Fax Number | 5415122082 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | TARA LYNETTE JEANNOT (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 5415356239 |
| Is Organization Subpart | Y |
| Parent Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022868 | 05 |
| Other Name | Type Code |
|---|---|
| La Clinica School-Based Health Center at Phoenix Elementary School | Doing Business As Name - Organization |
| School Based Health Center - Phoenix Elementary | Other Name - Individual/Organization |
| 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 |
| 1619368636 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 200 W Pine St, Central Point, OR 97502 | 2015-02-12 |
| 1497090971 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 713 Summit Avenue, Medford, OR 97501 | 2012-12-10 |
| 1205198470 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 655 N 3rd St, Central Point, OR 97502 | 2012-06-13 |
| 1003469354 | La Clinica Del Valle Family Health Care Center Inc. | Pharmacy | 730 Biddle Rd, Medford, OR 97504-6116 | 2019-07-16 |
| 1023660099 | La Clinica Del Valle Family Health Care Center Inc. | Pharmacy | 3617 S Pacific Hwy, Medford, OR 97501-8957 | 2019-07-10 |
| 1821572884 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 14235 Table Rock Rd, Central Point, OR 97502-9377 | 2018-09-17 |
| 1730663790 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 1500 2nd Ave, Gold Hill, OR 97525-9728 | 2018-09-17 |
| 1700379419 | La Clinica Del Valle Family Health Care Center Inc. | Internal Medicine | 1307 W Main St, Medford, OR 97501-2936 | 2018-06-08 |
| 1851816920 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 806 6th Ave N, Gold Hill, OR 97525 | 2017-08-09 |
| Street Address |
215 N ROSE ST |
| City | PHOENIX |
| State | OR |
| Zip Code | 97535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982729539 | Daniel Jansen | Counselor | 215 N Rose St, Phoenix, OR 97535 | 2007-03-20 |
| 1528616067 | Julie R Wiley | Registered Nurse | 215 N Rose St, Phoenix, OR 97535-5734 | 2019-08-28 |
| 1013227602 | Tamara Joy Chambers | Registered Nurse | 215 N Rose St, Phoenix, OR 97535-5734 | 2010-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417318577 | Brent M Gordon | Counselor | 5505 S Pacific Hwy, Phoenix, OR 97535 | 2016-03-16 |
| 1740649821 | Elizabeth Van Driel | Counselor | 149 N Main Street, Phoenix, OR 97535 | 2016-02-17 |
| 1740611458 | William Allen Haden Jr. | Social Worker | 106 N. Rose Street, Phoenix, OR 97535 | 2013-12-05 |
| 1528396470 | Sarah Bly | Midwife, Lay | 509 5th St., Phoenix, OR 97535 | 2009-12-03 |
| 1992961239 | Stephen J Brummett | Counselor | 482 Elm St, Phoenix, OR 97535 | 2008-08-06 |
| 1568680577 | Christine Carolyn Robinson | Chiropractor | 721 N. Main St., Space A, Phoenix, OR 97535 | 2007-04-23 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1760972160 | Jennifer L Burke | Counselor | 149 N Main Street, Phoenix, OR 97535 | 2018-05-11 |
| 1124552872 | Desiree Thompson | Counselor | 149 N Main St, Phoenix, OR 97535 | 2017-04-19 |
| 1376716571 | Phoenix Counseling Center, Inc. | Community/Behavioral Health | 149 S Main St, Phoenix, OR 97535 | 2008-04-08 |
| Find all providers in zip 97535 | ||||
| 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 |
|---|---|---|---|---|
| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| 1437607389 | Neighborhood Outreach Access To Health | Clinic/Center | 20440 N 27th Ave Ste 450, Phoenix, AZ 85027-3240 | 2016-09-20 |
| 1972907129 | Neighborhood Outreach Access To Health | Clinic/Center | 16251 N Cave Creek Rd, Phoenix, AZ 85032-2976 | 2014-10-17 |
| 1982830410 | Native Health | Clinic/Center | 2423 W Dunlap Ave Ste 140, Phoenix, AZ 85021-5818 | 2009-06-10 |
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1164055596 | Circle The City | Clinic/Center | 3522 N 3rd Ave, Phoenix, AZ 85013-3903 | 2020-02-13 |
| Find all providers in PHOENIX | ||||
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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.