NPIMap

Organization Active NPI

Indian Health Center of Santa Clara Valley

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1821564485
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Practice address
9501 Malech Rd
San Jose, CA 95138
Phone
(408) 445-3400
Fax
(408) 448-1727
NPI assigned
Oct 22, 2018
Last updated
Oct 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Authorized official

Name
Aldon Wayne Scott, DM
Title
Director of Operations
Phone
(408) 445-3400

Specialties & licenses 1

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

Addresses

Primary practice location

9501 Malech Rd
San Jose, CA 95138

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
FAC11833FMedicaidCA

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

Locations

9501 Malech Dr
San Jose, CA 95138

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1821564485",
    "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": "408-448-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 MALECH RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95138",
            "telephone_number": "408-445-3400",
            "fax_number": "408-448-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN HEALTH CENTER OF SANTA CLARA VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "ALDON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "408-445-3400",
        "authorized_official_credential": "DM"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FAC11833F",
            "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 Oct 22, 2018; 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.