NPIMap

Organization Active NPI

Tiburcio Vasquez Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hayward, CA
National Provider Identifier
1073676243
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
140000705 Issued in CA
Legal business name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Practice address
22331 Mission Blvd
Hayward, CA 94541
Phone
(510) 471-5880
Fax
(510) 690-0703
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Authorized official

Name
Andrea Schwab-Galindo
Title
Chief Executive Officer
Phone
(510) 460-3855

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X 140000705 CA Primary

Addresses

Primary practice location

22331 Mission Blvd
Hayward, CA 94541

Mailing address

22331 Mission Blvd
Hayward, CA 94541
Phone (510) 471-5880

Other identifiers 3

IdentifierTypeStateIssuer
FHC71039FMedicaidCA
HAP71039FOtherCAEDS
05-1102OtherCAMEDICARE FQHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040309001428 CA Part B Supplier - Clinic/Group Practice 6608764709 Receives reassigned benefits from 28 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hayward, CA; Union City, CA; San Leandro, CA; Castro Valley, CA
O20070904000618 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608764709 Practice locations: Hayward, CA

Federally qualified health center certification: CCN 051102

Legal name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 27, 2007
Last certification
Sep 27, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 1971 in CA
Enrollment address
22331 Mission Blvd
Hayward, CA 94541-3911

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

16110 E 14th St
Ashland, CA 94578
Phone (510) 398-7500

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennie Reyes Individual Corporate DirectorBoard Member Feb 1, 2016
Carla Ramirez Individual Corporate Director Aug 1, 2018
Jesse Robles Individual Corporate Director Aug 17, 2007
Minyon Corcuchia Garde Individual Corporate Director Feb 1, 2013
Andrea Schwab-Galindo Individual Corporate OfficerChief Executive Officer Jan 18, 2020
Josue Hernandez Individual Corporate Director May 1, 2015
Monica Salgado Individual W-2 Managing EmployeeFacilities Director Oct 30, 1990
Jaime Patino Individual Corporate Director Jul 1, 2014
Nancy Soto Individual Corporate Director Aug 17, 2007

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649030400000",
    "number": "1073676243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "94541",
            "telephone_number": "510-471-5880",
            "fax_number": "510-690-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "94541",
            "telephone_number": "510-471-5880",
            "fax_number": "510-690-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBURCIO VASQUEZ HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "SCHWAB-GALINDO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "510-460-3855"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "140000705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC71039F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDS",
            "identifier": "HAP71039F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "05-1102",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.