NPIMap

Organization Active NPI

Gardner Family Health Network Inc

Doing business as Alviso Health Center

  • Federally Qualified Health Center (FQHC)
  • Alviso, CA
National Provider Identifier
1164552931
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
FHC70262F Issued in CA
Legal business name
GARDNER FAMILY HEALTH NETWORK INC
Doing business as
Alviso Health Center
Practice address
1621 Gold St.
Alviso, CA 95002-1240
Phone
(408) 935-3933
Fax
(408) 935-3988
NPI assigned
Mar 7, 2007
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Christina Cornell
Title
Supervisor
Phone
(408) 579-6178

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Supports Brokerage Agency 251X00000X
Federally Qualified Health Center (FQHC) 261QF0400X FHC70262F CA Primary

Addresses

Primary practice location

1621 Gold St.
Alviso, CA 95002-1240

Mailing address

1621 Gold St.
PO Box 1240
Alviso, CA 95002
Phone (408) 935-3933

Other names 1

  • ALVISO HEALTH CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140213001174 CA Part A Provider - Federally Qualified Health Center (FQHC) 5890859375 Practice locations: Alviso, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164552931. Details of each certification follow.

Federally qualified health center certification: CCN 051812

Legal name
GARDNER FAMILY HEALTH NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1974 in CA
Enrollment address
1621 Gold St
Alviso, CA 95002-3530

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Almaden Health Center33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Hilda Bocanegra Individual Corporate Director Jul 1, 2022
Allison L Escho Individual Corporate Director Jul 1, 2022
Adolfo Gomez Porras Individual Corporate DirectorBoard Member Jan 1, 2015
Guillermo Viveros Individual Corporate OfficerInterim Ceo/Cfo Nov 1, 2025
W-2 Managing EmployeeCfo Nov 1, 2025
William Roth Individual Corporate DirectorBoard Member Mar 1, 2015
Noe Pablo Lozano Individual Corporate DirectorBoard Member Jul 1, 1997
Frank V Serrano Individual Corporate DirectorBoard Member Jun 15, 2004
Patricia Gutierrez Individual Corporate DirectorBoard Member Jan 1, 2015

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1164552931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 GOLD ST.",
            "address_2": "PO BOX 1240",
            "city": "ALVISO",
            "state": "CA",
            "postal_code": "95002",
            "telephone_number": "408-935-3933",
            "fax_number": "408-935-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 GOLD ST.",
            "city": "ALVISO",
            "state": "CA",
            "postal_code": "950021240",
            "telephone_number": "408-935-3933",
            "fax_number": "408-935-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDNER FAMILY HEALTH NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "408-579-6178"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "FHC70262F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALVISO HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ALVISO HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alviso, CA

Sources for this page

Verify at the official NPI Registry.