LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (NPI# 1831492156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831492156 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC |
| Other Organization Name | WEST MEDFORD HEALTH CENTER - LA CLINICA |
| Practice Address |
1307 W Main St Medford OR 97501-2936 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5415356239 |
| Practice Fax Number | 5415354377 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2019-07-15 |
| Authorized Official Name | MS. BRENDA IRENE JOHNSON (CEO) |
| Authorized Official Telephone | 5415123151 |
| Authorized Official Credential | RN, MBA |
| 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) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 022868 | 05 |
| Other Name | Type Code |
|---|---|
| West Medford Health Center - La Clinica | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417372731 | La Clinica Del Valle Family Health Care Center Inc | Clinic/Center | 910 S Central Ave, Medford, OR 97501-7822 | 2014-02-24 |
| 1942503248 | La Clinica Del Valle Family Health Care Center Inc | Clinic/Center | 4940 Hamrick Road, Central Point, OR 97502-3072 | 2010-12-09 |
| Street Address |
1307 W MAIN ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-2936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265402440 | Daniel James Sengenberger | Family Medicine | 1307 W Main St, Medford, OR 97501-2936 | 2006-01-23 |
| 1912506080 | Maura Mayerle | Registered Nurse | 1307 W Main St, Medford, OR 97501-2936 | 2020-10-20 |
| 1497376826 | Stacey Andrews | Nurse Practitioner | 1307 W Main St, Medford, OR 97501-2936 | 2020-04-27 |
| 1720555006 | Kimberly Rojas | Registered Nurse | 1307 W Main St, Medford, OR 97501-2936 | 2018-10-25 |
| 1700379419 | La Clinica Del Valle Family Health Care Center Inc. | Internal Medicine | 1307 W Main St, Medford, OR 97501-2936 | 2018-06-08 |
| 1275081366 | Shawna Harney | Registered Nurse | 1307 W Main St, Medford, OR 97501-2936 | 2016-09-17 |
| 1689028680 | Diana Marcela Cazares | Counselor | 1307 W Main St, Medford, OR 97501-2936 | 2016-04-16 |
| 1578963443 | Lori Braughton | Nurse Practitioner | 1307 W Main St, Medford, OR 97501-2936 | 2014-08-28 |
| 1366755019 | Jessica Nawoichik | Nurse Practitioner | 1307 W Main St, Medford, OR 97501-2936 | 2010-07-23 |
| 1134302250 | La Clinica Del Valle Family Healthcare Center Inc. | Counselor | 1307 W Main St, Medford, OR 97501-2936 | 2007-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| 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 |
| 1184237489 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 1011 La Loma Dr, Medford, OR 97504-8613 | 2020-08-26 |
| 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 |
| 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.