NPIMap

Organization Active NPI

La Clinica de la Raza, Inc.

Doing business as Casa Del Sol

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
National Provider Identifier
1174639116
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
140000171 Issued in CA
Legal business name
LA CLINICA DE LA RAZA, INC.
Doing business as
Casa Del Sol
Practice address
1501 Fruitvale Ave
Oakland, CA 94601-2322
Phone
(510) 535-6200
NPI assigned
Aug 22, 2006
Last updated
Feb 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Authorized official

Name
Ms. Jane Garcia
Title
Chief Executive Officer
Phone
(510) 535-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 140000171 CA Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 140000171 CA

Addresses

Primary practice location

1501 Fruitvale Ave
Oakland, CA 94601-2322

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

Other identifiers 3

IdentifierTypeStateIssuer
FHC80040FMedicaidCA
05-1063OtherCAMEDICARE PART A
ZZZ29799ZOtherCAMEDICARE PART B

Other names 1

  • Casa Del Sol Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227001016 CA Part B Supplier - Clinic/Group Practice 1557258282 Receives reassigned benefits from 204 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vallejo, CA; Pittsburg, CA; Oakley, CA; Oakland, CA; Concord, CA
O20061031000587 CA Part A Provider - Federally Qualified Health Center (FQHC) 1557258282 Practice locations: Oakland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174639116. Details of each certification follow.

Federally qualified health center certification: CCN 051063

Legal name
LA CLINICA DE LA RAZA INC
Doing business as
CASA DEL SOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 16, 2006
Last certification
Nov 16, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1971 in CA
Enrollment address
1423 Fruitvale Ave
Oakland, CA 94601-2320

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
La Clinica de la Raza Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

1423 Fruitvale Ave
Oakland, CA 94601

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Yvonne Hudson-Harmon Individual Corporate DirectorBoard Member Apr 19, 2004
Aisha Hampton-Bowser Individual Corporate DirectorBoard Member Dec 8, 2007
Maria Caldera Individual Corporate DirectorBoard Member Oct 1, 2013
Sophia E Bucheli Individual Corporate DirectorBoard Member Dec 1, 2016
Jill Noonan Individual Corporate DirectorBoard Member Nov 18, 2002
Jane Garcia Individual Corporate OfficerChief Executive Officer Oct 26, 2006
W-2 Managing EmployeeChief Executive Officer Oct 26, 2006
Elizabeth Diaz Individual Corporate DirectorBoard Member Jul 17, 2017
Ramon J Terrazas Individual Corporate OfficerPresident Jul 1, 2013
Corporate DirectorBoard Member Nov 25, 1997
Rodney Leggett Individual Corporate DirectorBoard Member Sep 17, 2012
Maria Tsaklanos Individual Corporate DirectorBoard Member Jul 17, 2017
Robert Katter Individual Corporate Director May 16, 2005
Norma Guerrero Individual Corporate Director Jan 20, 2000
Andrew Cleophas Peterson Individual Corporate DirectorBoard Member Oct 1, 2013
Paul M Swenson Individual Corporate OfficerTreasurer Jul 18, 2012
Corporate DirectorBoard Member, Treasurer Jul 9, 2008
Dora Eckenfelder Individual Corporate DirectorBoard Member Jul 17, 2017

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771459200000",
    "number": "1174639116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DE LA RAZA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "510-535-4000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "140000171",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "140000171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC80040F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A",
            "identifier": "05-1063",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "ZZZ29799Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Del Sol",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Casa Del Sol",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.