NPIMap

Organization Active NPI

Indian Health Center of Santa Clara Valley

  • Multi-Specialty Clinic/Center
  • San Jose, CA
National Provider Identifier
1427216308
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
070000118 Issued in CA
Legal business name
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Practice address
1333 Meridian Ave
San Jose, CA 95125-5212
Phone
(408) 445-3400
Fax
(408) 448-1041
NPI assigned
May 28, 2008
Last updated
Jun 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Wanda E Edmo
Title
Human Resource Director
Phone
(408) 445-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 070000118 CA Primary

Addresses

Primary practice location

1333 Meridian Ave
San Jose, CA 95125-5212

Mailing address

1333 Meridian Ave
San Jose, CA 95125-5212
Phone (408) 445-3400

Other identifiers 1

IdentifierTypeStateIssuer
HAP11833FOtherCAFAMILY PACT PROGRAM

National Provider Directory

National Provider Directory
Tax ID family
Indian Health Ctr SC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1427216308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255212",
            "telephone_number": "408-445-3400",
            "fax_number": "408-448-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 MERIDIAN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255212",
            "telephone_number": "408-445-3400",
            "fax_number": "408-448-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN HEALTH CENTER OF SANTA CLARA VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "EDMO",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "HUMAN RESOURCE DIRECTOR",
        "authorized_official_telephone_number": "408-445-3400"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "070000118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT PROGRAM",
            "identifier": "HAP11833F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 30, 2011; 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.