NPIMap

Organization Active NPI

South County Community Health Center Inc.

  • Primary Care Clinic/Center
  • East Palo Alto, CA
National Provider Identifier
1376697482
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
05245 Issued in CA
Legal business name
SOUTH COUNTY COMMUNITY HEALTH CENTER INC.
Practice address
1798 Bay Rd # a
East Palo Alto, CA 94303-1611
Phone
(650) 330-7400
Fax
(650) 321-1156
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Authorized official

Name
Mr. Wayne Yost
Title
Chief Financial Officer
Phone
(650) 330-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 05245 CA Primary

Addresses

Primary practice location

1798 Bay Rd # a
East Palo Alto, CA 94303-1611

Mailing address

1798 Bay Rd # a
East Palo Alto, CA 94303-1611
Phone (650) 330-7400

Other identifiers 2

IdentifierTypeStateIssuer
4CDJ56M23R2107497OtherCAVIN
FHC70935FMedicaidCA

Other names 1

  • Ravenswood Family Health Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1376697482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1798 BAY RD # A",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-330-7400",
            "fax_number": "650-321-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 BAY RD # A",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943031611",
            "telephone_number": "650-330-7400",
            "fax_number": "650-321-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "YOST",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "650-330-7400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "05245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIN",
            "identifier": "4CDJ56M23R2107497",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70935F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravenswood Family Health Center",
            "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 Jun 11, 2008; 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.