NPIMap

Organization Active NPI

Tiburcio Vasquez Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hayward, CA
National Provider Identifier
1790256808
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Practice address
25555 Hesperian Blvd RM 2315
Hayward, CA 94545-2447
Phone
(510) 471-5907
NPI assigned
Dec 16, 2018
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
TIBUCIO VASQUEZ HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Andrea Schwab-Galindo
Title
Chief Executive Officer
Phone
(510) 460-3855

Specialties & licenses 1

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

Addresses

Primary practice location

25555 Hesperian Blvd RM 2315
Hayward, CA 94545-2447

Mailing address

22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 471-5907

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

Other names 1

  • Chabot College Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040309001428 CA Part B Supplier - Clinic/Group Practice 6608764709 Receives reassigned benefits from 28 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hayward, CA; Union City, CA; San Leandro, CA; Castro Valley, CA
O20140912000552 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608764709 Practice locations: Hayward, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790256808. Details of each certification follow.

Federally qualified health center certification: CCN 921813

Legal name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 22, 2019
Last certification
Jul 22, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 26, 1971 in CA
Enrollment address
25555 Hesperian Blvd
Hayward, CA 94545-2447

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Tiburcio Vasquez Health14 organizations share this tax ID, including this one
Part of
Tiburcio Vasquez Health

Other organizations with this tax ID 13

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

View all 13

Locations

33255 9th St
Union City, CA 94587
Phone (510) 690-6052

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vipan Bajwa Individual Corporate DirectorBoard Member Jul 1, 2023
Jennie Reyes Individual Corporate DirectorBoard Member Feb 1, 2016
Scott Coffin Individual Corporate DirectorBoard Member May 1, 2023
Jesse Robles Individual Corporate DirectorBoard Member Sep 1, 2005
Minyon Corcuchia Garde Individual Corporate DirectorBoard Member Feb 1, 2013
Andrea Schwab-Galindo Individual Corporate OfficerChief Executive Officer Jan 18, 2020
W-2 Managing EmployeeChief Executive Officer Feb 4, 2013
Josue Hernandez Individual Corporate DirectorBoard Member May 1, 2015
Monica Salgado Individual W-2 Managing EmployeeSr. Director of Facilities Oct 29, 1990
Jaime Patino Individual Corporate DirectorBoard Member Jul 1, 2014
Nancy Soto Individual Corporate DirectorBoard Member Feb 1, 1997

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1790256808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5907",
            "fax_number": "510-690-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25555 HESPERIAN BLVD RM 2315",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452447",
            "telephone_number": "510-471-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBURCIO VASQUEZ HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIBUCIO VASQUEZ HEALTH CENTER, INC.",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "SCHWAB-GALINDO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "510-460-3855"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chabot College",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.