NPIMap

Organization Active NPI

San Jose Foothill Family Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1104244821
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.
Practice address
3200 Senter Road
Room S-104
San Jose, CA 95111-1332
Phone
(408) 347-4240
Fax
(866) 931-7822
NPI assigned
Mar 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

3200 Senter Road
Room S-104
San Jose, CA 95111-1332

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
Tax ID family
San Jose Foothill Family Community Clinic15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1104244821",
    "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": "3200 SENTER ROAD",
            "address_2": "ROOM S-104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111332",
            "telephone_number": "408-347-4240",
            "fax_number": "866-931-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-31",
        "last_updated": "2015-06-09",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "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 9, 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.