Roots Community Health Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ROOTS COMMUNITY HEALTH CENTER

Practice address

1898 The Alameda
San Jose, CA 95126-1733

Phone

(408) 490-4710

Fax

(510) 550-2644

NPI assigned

Mar 21, 2017

Last updated

Oct 27, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

ROOTS COMMUNITY HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Jerusha Norman

Title

Compliance Administrator

Phone

(510) 994-6849

Specialties & licenses 5

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Roots Community Health6 organizations share this tax ID, including this one

Part of

Roots Community Health

Other organizations with this tax ID 5

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

• Roots Community Health Center

  • Primary Care Clinic/Center
  • Oakland, CA
  • NPI 1083858823
  NPD tax ID
• Roots Community Health Center

  • Family Medicine Physician
  • Oakland, CA
  • NPI 1811530991
  NPD tax ID
• Roots Community Health Center

  • Primary Care Clinic/Center
  • Oakland, CA
  • NPI 1851785307
  NPD tax ID
• Roots Community Health Center

  • Primary Care Clinic/Center
  • Oakland, CA
  • NPI 1932663853
  NPD tax ID
• Roots Community Health Center

  • Family Medicine Physician
  • Oakland, CA
  • NPI 1952942575
  NPD tax ID

Locations

Practitioners 1

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.

• Noha Mandouh Aboelata, MD

  • Family Medicine Physician
  • Oakland, CA
  • NPI 1447246293
  NPD (past)

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698364800000",
    "number": "1083145122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 INTERNATIONAL BLVD",
            "address_2": "#5",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032558",
            "telephone_number": "510-777-1177",
            "fax_number": "510-550-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1898 THE ALAMEDA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261733",
            "telephone_number": "408-490-4710",
            "fax_number": "510-550-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROOTS COMMUNITY HEALTH CENTER",
        "enumeration_date": "2017-03-21",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "JERUSHA",
        "authorized_official_title_or_position": "COMPLIANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "510-994-6849"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wenqiang Rong, DDS
• Claudine Lauren Ronquillo
• Shayda Roohparvar
• Rebecca Marie Rook, ACSW
• Root of Health Acupuncture & Wellness Inc. (Root of Health Acupuncture & Wellness)
• Rebecca Roots
• Alison Roozeboom, MS, OTR/L
• Jocelyn Wilgem Roque
• Leah Roque, C.N.A, H.H.A.
• Samantha Gabrielle Bonifacio Roque

• Primary Care Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.