LA CLINICA DE LA RAZA INC NPI 1780606632

NPI Information

  • NPI: 1780606632
  • Provider Name: LA CLINICA DE LA RAZA INC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: LA CLINICA VALLEJO DENTAL
  • CLIA Number: 05D0601766
  • Address: 2920A SONOMA BLVD
    VALLEJO, CA
    ZIP 94590
  • Phone: (707) 558-2000

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NPI Details

LA CLINICA DE LA RAZA INC is a dental clinic center in Vallejo, CA. LA CLINICA DE LA RAZA INC NPI is 1780606632. The provider is registered as an organization entity type.
The provider Is Doing Business As La Clinica Vallejo Dental.

The provider's business location address is:

2920A SONOMA BLVD
VALLEJO, CA
ZIP 94590-879
Phone: (707) 558-2000
Fax: (707) 644-3507

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 CLIA number assigned to this NPI record is 05D0601766 - federally qualified health center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 8/22/2020.

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
1261QD0000XClinic/CenterDentalYes
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)CALIFORNIAX

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
1FHC70833FMEDICAIDCALIFORNIA

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: 3/30/2025

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