GARDNER FAMILY HEALTH NETWORK INC NPI 1407985534

NPI Information

NPI: 1407985534
Provider Name: GARDNER FAMILY HEALTH NETWORK INC

Doing Business As: GARDNER HEALTH CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D2050446

Address:
195 E VIRGINIA ST
SAN JOSE, CA
ZIP 95112
Phone: (408) 935-3933
Get Directions

GARDNER FAMILY HEALTH NETWORK INC is a federally qualified health center (fqhc) clinic center in San Jose, CA. GARDNER FAMILY HEALTH NETWORK INC NPI is 1407985534. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gardner Health Center.

The provider's business location address is:

195 E VIRGINIA ST
SAN JOSE, CA
ZIP 95112-844
Phone: (408) 935-3933
Fax: (408) 935-3988

The provider's authorized official is Ofelia Ruiz .
The authorized official title is Director and has the following contact phone number (408) 935-3971.

The CLIA number assigned to this NPI record is 05D2050446 - other - mobile health unit with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 5/4/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator				No
2	251X00000X	Supports Brokerage				No
3	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	FHC70262F	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	FHC11531F	MEDICAID	CALIFORNIA
2	BCO11531F	OTHER	CALIFORNIA	BCEDPGAR
3	EAP11531F	OTHER	CALIFORNIA	EAPCGAR
4	HAP11531F	OTHER	CALIFORNIA	SOFPGAR

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: 4/28/2024

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