San Jose/Evergreen Community College District

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

License

EXE70004F Issued in CA

Legal business name

SAN JOSE/EVERGREEN COMMUNITY COLLEGE DISTRICT

Practice address

3095 Yerba Buena Rd
San Jose, CA 95135-1513

Phone

(408) 270-6480

Fax

(408) 532-1831

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Janice Assadi, RN

Title

Director of Student Health Services

Phone

(408) 274-7900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Evergreen Valley CollegeStudent Health Services Doing business as

Tax ID family

Evergreen Valley Collegestudent Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• San Jose City College Student Health Services

  • Student Health Clinic/Center
  • San Jose, CA
  • NPI 1396792875
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Nga Tran, FNP-C

  • Family Nurse Practitioner
  • Carlsbad, CA
  • NPI 1508337387
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1497975882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 YERBA BUENA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351513",
            "telephone_number": "408-270-6480",
            "fax_number": "408-532-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 YERBA BUENA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351513",
            "telephone_number": "408-270-6480",
            "fax_number": "408-532-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE/EVERGREEN COMMUNITY COLLEGE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "ASSADI",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "DIRECTOR OF STUDENT HEALTH SERVICES",
        "authorized_official_telephone_number": "408-274-7900",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "CA",
            "license": "EXE70004F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EXE70004F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Valley CollegeStudent Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Jose State University Student Health Center
• San Jose Surgical Group
• San Jose Therapy, a Licensed Clinical Social Worker Corporation
• San Jose Usd
• San Jose Womens Medical Group Inc
• Carlos Manuel Angeles San Mateo, MD
• Kristina Cassandra San Miguel
• Tony San Miguel
• Juancho Miguel San Pedro
• Amarilis San Vicente, DDS

• Student Health Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Student Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.