LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. (NPI# 1891061784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891061784 |
| Entity Type | Organization |
| Organization Name | LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. |
| Other Organization Name | EAST MEDFORD DENTAL CLINIC-LA CLINICA |
| Practice Address |
1113 Progress Dr Medford OR 97504 |
| Mailing Address |
931 Chevy Way Medford OR 97504-4127 |
| Practice Telephone | 5415123900 |
| Practice Fax Number | 5414141175 |
| Mailing Telephone | 5415356239 |
| Mailing Fax Number | 5418422212 |
| Enumeration Date | 2012-03-26 |
| 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) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| East Medford Dental Clinic | Other Name - Individual/Organization |
| East Medford Dental Clinic-La Clinica | Doing Business As Name - 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 |
1113 PROGRESS DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811965593 | Kimberly Leeds Heeter | Dentist | 1113 Progress Dr, Medford, OR 97504-5201 | 2006-03-09 |
| 1790346013 | Kyle M Pett | Dentist | 1113 Progress Dr, Medford, OR 97504-5201 | 2019-06-26 |
| 1083115737 | Dennae Lee Sandoe | Dental Hygienist | 1113 Progress Dr, Medford, OR 97504-5201 | 2018-02-27 |
| 1720586910 | Ayse Van Lienden | Dental Hygienist | 1113 Progress Dr, Medford, OR 97504-5201 | 2018-01-23 |
| 1801312376 | Ashley Stephens | Dental Hygienist | 1113 Progress Dr, Medford, OR 97504-5201 | 2017-08-16 |
| 1477083145 | Erin M Watkins | Denturist | 1113 Progress Dr, Medford, OR 97504 | 2017-06-15 |
| 1831627348 | Alayna Louise Schoblaske | Dentist | 1113 Progress Dr, Medford, OR 97504-5201 | 2017-05-28 |
| 1053854125 | Rachel Murdock | Dental Hygienist | 1113 Progress Dr, Medford, OR 97504-5201 | 2016-11-22 |
| 1154773851 | Mairelys Onate | Dentist | 1113 Progress Dr, Medford, OR 97504-5201 | 2016-07-06 |
| 1407218498 | Shantell E Dendauw | Dental Hygienist | 1113 Progress Dr, Medford, OR 97504-5201 | 2016-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| 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.