NPIMap

Organization Active NPI

South County Community Health Center, Inc.

Doing business as Ravenswood Family Health Center Pharmacy

  • Federally Qualified Health Center (FQHC)
  • East Palo Alto, CA
National Provider Identifier
1245695881
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
PHY53775 Issued in CA
Legal business name
SOUTH COUNTY COMMUNITY HEALTH CENTER, INC.
Doing business as
Ravenswood Family Health Center Pharmacy
Practice address
1885 Bay Rd
East Palo Alto, CA 94303-1312
Phone
(650) 330-7400
Fax
(650) 321-1560
NPI assigned
Dec 28, 2015
Last updated
Feb 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Authorized official

Name
Ms. Luisa Buada, RN,MPH
Title
Ceo
Phone
(650) 330-7410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X PHY53775 CA Primary

Addresses

Primary practice location

1885 Bay Rd
East Palo Alto, CA 94303-1312

Mailing address

1885 Bay Rd
Suite a
East Palo Alto, CA 94303-1312
Phone (650) 330-7400

Other names 1

  • Ravenswood Family Health Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southcommunityhealthcenteri5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1885 Bay Rd
Ste A
East Palo Alto, CA 94303
Phone (650) 330-7457

Practitioners & affiliated clinicians

Practitioners 1

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": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456099200000",
    "number": "1245695881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 BAY RD",
            "address_2": "SUITE A",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031312",
            "telephone_number": "650-330-7400",
            "fax_number": "650-321-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 BAY RD",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031312",
            "telephone_number": "650-330-7400",
            "fax_number": "650-321-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2016-02-22",
        "status": "A",
        "authorized_official_last_name": "BUADA",
        "authorized_official_first_name": "LUISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-330-7410",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN,MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "PHY53775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravenswood Family Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.