NPIMap

Organization Active NPI

Gardner Family Health Network Inc

Doing business as Independence High School

  • Community/Behavioral Health Agency
  • San Jose, CA
National Provider Identifier
1255150561
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GARDNER FAMILY HEALTH NETWORK INC
Doing business as
Independence High School
Practice address
617 N Jackson Ave
San Jose, CA 95133-2345
Phone
(408) 938-2112
NPI assigned
Oct 4, 2024
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Laura Perez
Title
Credentialing Specialist
Phone
(408) 938-2113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

617 N Jackson Ave
San Jose, CA 95133-2345

Mailing address

617 N Jackson Ave
San Jose, CA 95133-2345
Phone (408) 938-2112

Other names 1

  • Independence High School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Health Fndtn Alv33 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

NPI Registry JSON

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1255150561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951332345",
            "telephone_number": "408-938-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951332345",
            "telephone_number": "408-938-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDNER FAMILY HEALTH NETWORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "408-938-2113"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence High School",
            "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 Oct 4, 2024; 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.