NPIMap

Organization Active NPI

Genesis Clinica de la Mujer Inc

Doing business as Genesis Clinica de la Mujer

  • Obstetrics & Gynecology Physician
  • San Jose, CA
National Provider Identifier
1194048884
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G81814 Issued in CA
Legal business name
GENESIS CLINICA DE LA MUJER INC
Doing business as
Genesis Clinica de la Mujer
Practice address
244 N Jackson Ave
Suite 209
San Jose, CA 95116-1604
Phone
(408) 258-3724
Fax
(408) 258-3736
NPI assigned
Mar 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Mrs. Rosa Elena Heredia, MSNNPI 1033212691
Title
President
Phone
(408) 258-3724

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X G75190 CA
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X G81814 CA Primary
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LX0001X NP9507 CA

Addresses

Primary practice location

244 N Jackson Ave
Suite 209
San Jose, CA 95116-1604

Mailing address

244 N Jackson Ave
Suite 209
San Jose, CA 95116-1604
Phone (408) 258-3724

Other names 1

  • Genesis Clinica de la Mujer Doing business as

National Provider Directory

National Provider Directory

Locations

244 N Jackson Ave
Ste 209
San Jose, CA 95116
Phone (408) 258-3724

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1194048884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 N JACKSON AVE",
            "address_2": "SUITE 209",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161604",
            "telephone_number": "408-258-3724",
            "fax_number": "408-258-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 N JACKSON AVE",
            "address_2": "SUITE 209",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161604",
            "telephone_number": "408-258-3724",
            "fax_number": "408-258-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CLINICA DE LA MUJER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "HEREDIA",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-258-3724",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G75190",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G81814",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "NP9507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Clinica de la Mujer",
            "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 Nov 14, 2011; 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.