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LA CLINICA DE LA RAZA INC NPI 1346262292


NPI Information

NPI: 1346262292
Provider Name: LA CLINICA DE LA RAZA INC

Doing Business As: LA CLINICA DENTAL AT CHILDREN'S HOSPITAL OAKLAND

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4881 TELEGRAPH AVE
OAKLAND, CA
ZIP 94609
Phone: (510) 428-3316
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LA CLINICA DE LA RAZA INC is a federally qualified health center (fqhc) clinic center in Oakland, CA. LA CLINICA DE LA RAZA INC NPI is 1346262292. The provider is registered as an organization entity type.
The provider Is Doing Business As La Clinica Dental At Children's Hospital Oakland.

The provider's business location address is:

4881 TELEGRAPH AVE
OAKLAND, CA
ZIP 94609-009
Phone: (510) 428-3316
Fax: (510) 450-5806

The provider's authorized official is Jane Garcia .
The authorized official title is Chief Executive Officer and has the following contact phone number (510) 535-4000.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 2/6/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QD0000XClinic/CenterDentalNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)140000670CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1FHC71017FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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