NPIMap

Organization Active NPI

Health for All - Revere Clinic

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
National Provider Identifier
1063965952
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
030000221 Issued in CA
Legal business name
HEALTH FOR ALL - REVERE CLINIC
Practice address
752 Revere St
Unit B
Sacramento, CA 95818-2073
Phone
(916) 441-2811
Fax
(916) 441-2876
NPI assigned
Jul 27, 2016
Organization subpart
Yes
Parent organization
HEALTH FOR ALL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Mr. Chuck Wiesen
Title
Ceo
Phone
(916) 441-2811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 030000221 CA Primary

Addresses

Primary practice location

752 Revere St
Unit B
Sacramento, CA 95818-2073

Mailing address

420 I Street
Suite 7
Sacramento, CA 95814-2319
Phone (916) 441-2811

National Provider Directory

National Provider Directory
Tax ID family
Health for All Las Palm7 organizations share this tax ID, including this one
Part of
Health for All Las Palm

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

420 I St
Ste 7
Sacramento, CA 95814
Phone (916) 441-2811

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1063965952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 I STREET",
            "address_2": "SUITE 7",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142319",
            "telephone_number": "916-441-2811",
            "fax_number": "916-441-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 REVERE ST",
            "address_2": "UNIT B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958182073",
            "telephone_number": "916-441-2811",
            "fax_number": "916-441-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH FOR ALL - REVERE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH FOR ALL, INC.",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "WIESEN",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-441-2811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "030000221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.