INDIAN HEALTH CENTER OF SANTA CLARA VALLEY (NPI# 1881997963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881997963 |
| Entity Type | Organization |
| Organization Name | INDIAN HEALTH CENTER OF SANTA CLARA VALLEY |
| Other Organization Name | INDIAN HEALTH CENTER OF SANTA CLARA |
| Practice Address |
1642 E Capitol Expy San Jose CA 95121-1800 |
| Mailing Address |
1333 Meridian Ave San Jose CA 95125-5212 |
| Practice Telephone | 4084453400 |
| Practice Fax Number | 4084481727 |
| Mailing Telephone | 4084453400 |
| Mailing Fax Number | 4084481727 |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2013-02-07 |
| Authorized Official Name | DR. ALDON WAYNE SCOTT (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 4084453400 |
| Authorized Official Credential | D.M. |
| Is Organization Subpart | Y |
| Parent Organization Name | INDIAN HEALTH CENTER OF SANTA CLARA VALLEY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550001783 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE PROGRAMS | FHC11833F | 01 |
| CA | MEDICARE PALMETTO | 55-1120 | 01 |
| CA | FHC11833F | 05 | |
| CA | DELTA DENTAL | G01133-01 | 01 |
| Other Name | Type Code |
|---|---|
| Indian Health Center of Santa Clara | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1437607355 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 204b, San Jose, CA 95128-4815 | 2016-09-20 |
| 1629462312 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 105, San Jose, CA 95128-4815 | 2015-03-20 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1538529052 | Indian Health Center of Santa Clara Valley | Clinic/Center | 25 N 14th St Ste 140, San Jose, CA 95112-6218 | 2016-02-25 |
| 1326425265 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2030 Forest Ave Ste 110, San Jose, CA 95128-4833 | 2015-04-29 |
| 1114290780 | Indian Health Center of Santa Clara Valley | Clinic/Center | 455 Oconnor Dr Ste 200, San Jose, CA 95128-1632 | 2012-02-13 |
| 1366726903 | Indian Health Center of Santa Clara Valley | Clinic/Center | 602 E Santa Clara St, San Jose, CA 95112-1908 | 2011-09-30 |
| 1518240118 | Indian Health Center of Santa Clara Valley | Clinic/Center | 602 E Santa Clara St, Suite 230, San Jose, CA 95112-1908 | 2011-09-21 |
| 1629236500 | Indian Health Center of Santa Clara Valley | Clinic/Center | 602 E Santa Clara St, Suite 230, San Jose, CA 95112-1908 | 2008-05-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDIAN HEALTH CENTER OF SANTA CLARA VALLEY | 1333 Meridian Ave, San Jose, CA 95125-5212 |
| Street Address |
1642 E CAPITOL EXPY |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95121-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659310902 | Christopher Minh Vu | Pediatrics | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-06-05 |
| 1356739973 | My-phuc Le | Family Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2015-01-05 |
| 1659502136 | Sonya Lobana | Family Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2009-08-02 |
| 1457536518 | Parivash Moody | Nurse Practitioner | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2008-01-08 |
| 1124044458 | Sarah Aoi Gaskins | Psychiatry & Neurology | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-13 |
| 1588689814 | Lam Huu Do | Internal Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-13 |
| 1215960455 | Evergreen Pediatric Associates Inc. | Pediatrics | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-09 |
| 1790718260 | Evergreen Medical Associates Inc | Internal Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922669597 | Tracy Filler, Dmd, Inc. | Dentist | 1569 Lexann Drive, Suite 202, San Jose, CA 95121 | 2019-06-25 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1538681325 | Sujata S Gawande | Dentist | 2060 Aborn Rd Ste 125, San Jose, CA 95121 | 2017-07-12 |
| 1871950188 | Keiana Harrington | Behavioral Analyst | 6958 Del Rio Dr., San Jose, CA 95121 | 2016-01-19 |
| 1679812556 | Hien Van Nguyen | Pediatrics | 1675 Burdette Dr, Ste #20, San Jose, CA 95121 | 2013-02-12 |
| 1013290766 | Minh V Nguy | Dentist | 3161 Senter Road, San Jose, CA 95121 | 2011-09-20 |
| 1528388139 | Vu V. Le Chiro | Chiropractor | 1059 E. Capitol Expressway, San Jose, CA 95121 | 2010-06-04 |
| 1205087012 | Lanni Huynh | Acupuncturist | 2936 Aborn Square, San Jose, CA 95121 | 2008-10-10 |
| 1598936676 | Soumya Shivanna | Dentist | 1620 E.capitol Expressway, Suite C, San Jose, CA 95121 | 2008-03-18 |
| 1144434903 | Jeremy D. Lai | Pharmacist | 1569 Lexann Avenue, Suite 104, San Jose, CA 95121 | 2007-05-10 |
| Find all providers in zip 95121 | ||||
| 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 |
|---|---|---|---|---|
| 1669094504 | Bay Area Community Health | Clinic/Center | 3434 Silver Creek Rd Rm M1, San Jose, CA 95121-1845 | 2020-05-14 |
| 1720600760 | Bay Area Community Health | Clinic/Center | 2880 Story Rd Ste 10, San Jose, CA 95127-3942 | 2020-05-13 |
| 1487276424 | Bay Area Community Health | Clinic/Center | 242 La Pala Dr Ste A&b, San Jose, CA 95127-2103 | 2020-05-13 |
| 1598387672 | Bay Area Community Health | Clinic/Center | 3200 Senter Rd Rm S104, San Jose, CA 95111-1332 | 2020-05-12 |
| 1962024059 | Bay Area Community Health | Clinic/Center | 1066 S White Rd Ste 170, San Jose, CA 95127-3812 | 2020-05-12 |
| 1407478597 | Bay Area Community Health | Clinic/Center | 1855 Lucretia Ave Bldg M, San Jose, CA 95122-3730 | 2020-05-12 |
| 1659993632 | Bay Area Community Health | Clinic/Center | 617 N Jackson Ave Bldg 1, San Jose, CA 95133-2345 | 2020-05-12 |
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1770027047 | San Jose Foothill Family Community Clinic, Inc. | Clinic/Center | 3434 Silver Creek Rd, Room M1, San Jose, CA 95121-1845 | 2016-12-06 |
| 1437607355 | Indian Health Center of Santa Clara Valley | Clinic/Center | 2039 Forest Ave Ste 204b, San Jose, CA 95128-4815 | 2016-09-20 |
| Find all providers in SAN JOSE | ||||
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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.