NPIMap

Organization Active NPI

La Clinica del Valle Family Healthcare Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Talent, OR
National Provider Identifier
1215540398
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.
Practice address
102 Christian Avenue
Talent, OR 97540
Phone
(541) 535-1552
Fax
(541) 512-2082
NPI assigned
Aug 28, 2020
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Traci Fossen
Title
Chief Quality Officer
Phone
(541) 512-3912

Specialties & licenses 1

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

Addresses

Primary practice location

102 Christian Avenue
Talent, OR 97540

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 535-6239

Other names 1

  • La Clinica School-Based Health Center Talent Middle School Other name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2193192La Clinica School Based Health Center at102 Christian Avenue, Talent, OR 97540Certificate of waiverSep 16, 2026

National Provider Directory

National Provider Directory
Tax ID family
La Clinica del Valle Family Health Care Center Inc33 organizations share this tax ID, including this one
Part of
La Clinica del Valle Family Health Care Center Inc

Other organizations with this tax ID 32

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

View all 32

Practitioners & affiliated clinicians

Practitioners 4

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": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1215540398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-535-6239",
            "fax_number": "541-842-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CHRISTIAN AVENUE",
            "city": "TALENT",
            "state": "OR",
            "postal_code": "97540",
            "telephone_number": "541-535-1552",
            "fax_number": "541-512-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA CLINICA DEL VALLE FAMILY HEALTHCARE CENTER INC.",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "FOSSEN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "541-512-3912"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Clinica School-Based Health Center Talent Middle School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Talent, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.