NPIMap

Organization Active NPI

San Jose Foothill Family Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1306223615
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
H80CS06646 Issued in CA
Legal business name
SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.
Practice address
2880 Story Rd
Suite 10
San Jose, CA 95127-3942
Phone
(408) 729-9700
NPI assigned
May 6, 2015
Organization subpart
Yes
Parent organization
SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Authorized official

Name
Salvador Chavarin
Title
Chief Executive Officer
Phone
(408) 729-4290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X H80CS06646 CA Primary

Addresses

Primary practice location

2880 Story Rd
Suite 10
San Jose, CA 95127-3942

Mailing address

2670 S White Rd
Suite 200
San Jose, CA 95148-2071
Phone (408) 729-4290

Other names 1

  • Foothill Community Mobile Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
San Jose Foothill Family Community Clinic15 organizations share this tax ID, including this one
Part of
San Jose Foothill Family Community Clinic

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1306223615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 S WHITE RD",
            "address_2": "SUITE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482071",
            "telephone_number": "408-729-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 STORY RD",
            "address_2": "SUITE 10",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273942",
            "telephone_number": "408-729-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JOSE FOOTHILL FAMILY COMMUNITY CLINIC, INC.",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "CHAVARIN",
        "authorized_official_first_name": "SALVADOR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "408-729-4290"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "H80CS06646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Community Mobile Clinic",
            "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 May 6, 2015; 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.