NPIMap

Organization Active NPI

San Jose Foothill Family Community Clinic, Inc.

Doing business as Foothill Community Health Center

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1063658029
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
070000436 Issued in CA
Legal business name
SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.
Doing business as
Foothill Community Health Center
Practice address
2880 Story Road
Suite 10
San Jose, CA 95127-3942
Phone
(408) 755-3920
Fax
(866) 931-7822
NPI assigned
Dec 22, 2008
Last updated
Jun 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Salvador Chavarin
Title
Chief Executive Officer
Phone
(408) 729-4290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 070000436 CA Primary

Addresses

Primary practice location

2880 Story Road
Suite 10
San Jose, CA 95127-3942

Mailing address

2670 South White Road
Suite 200
San Jose, CA 95148-2071
Phone (408) 729-4290

Other names 1

  • Foothill Community Health Center Doing business as

National Provider Directory

National Provider Directory

Locations

2680 S White Rd
Ste 260
San Jose, CA 95148
Phone (408) 528-8446

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1063658029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 SOUTH WHITE ROAD",
            "address_2": "SUITE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482071",
            "telephone_number": "408-729-4290",
            "fax_number": "866-931-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 STORY ROAD",
            "address_2": "SUITE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273942",
            "telephone_number": "408-755-3920",
            "fax_number": "866-931-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "CHAVARIN",
        "authorized_official_first_name": "SALVADOR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "408-729-4290"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "070000436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.