Organization Active NPI

Tiburcio Vasquez Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Union City, CA
National Provider Identifier
1851389696
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
140000137 Issued in CA
Legal business name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Practice address
33255 9TH St
Union City, CA 94587-2137
Phone
(510) 471-5880
Fax
(510) 471-9051
NPI assigned
Oct 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 140000705 CA
Clinic/Center 261Q00000X 140000504 CA
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X 140000137 CA Primary

Addresses

Primary practice location

33255 9TH St
Union City, CA 94587-2137

Mailing address

22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 690-6052

Other identifiers 8

IdentifierTypeStateIssuer
05-1103OtherCAMEDICARE FQHC
FHC11635FMedicaidCA
HAP11635FOtherEDS
FHC70644FOtherCAMEDICAL
ZZZ75101ZOtherCAMEDICARE
EAP11635FOtherEDS
FHC70476FOtherCAMEDICAL
CA118859OtherCAMEDICARE PTAN PART B

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
Practice locations: Hayward, CA; Union City, CA; San Leandro, CA; Castro Valley, CA
O20070827000935 CA Part A Provider - Federally Qualified Health Center (FQHC) 6608764709 Practice locations: Union City, CA

Federally qualified health center certification: CCN 051103

Legal name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 27, 2007
Last certification
Sep 27, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 26, 1971 in CA
Enrollment address
33255 9TH St
Union City, CA 94587-2137

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 Health Center14 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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Jennie Reyes Individual Corporate DirectorBoard Member Feb 1, 2016
Carla Ramirez Individual Corporate DirectorBoard Member Aug 1, 2018
Jesse Robles Individual Corporate OfficerBoard Member Aug 17, 2007
Minyon Corcuchia Garde Individual Corporate DirectorBoard Member Feb 1, 2013
Andrea Schwab-Galindo Individual Corporate OfficerChief Executive Officer Jan 18, 2020
W-2 Managing Employee Feb 4, 2013
Josue Hernandez Individual Corporate DirectorBoard Member May 1, 2015
Monica Salgado Individual W-2 Managing EmployeeExecutive Assistant Oct 20, 1991
Jaime Patino Individual Corporate OfficerBoard Member Jul 1, 2014
Nancy Soto Individual Corporate OfficerBoard Chair Aug 17, 2007

Practitioners & affiliated clinicians

Practitioners 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1851389696",
    "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": "510-690-6052",
            "fax_number": "510-690-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33255 9TH ST",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945872137",
            "telephone_number": "510-471-5880",
            "fax_number": "510-471-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBURCIO VASQUEZ HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "140000705",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "140000504",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "140000137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FQHC",
            "identifier": "05-1103",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC11635F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDS",
            "identifier": "HAP11635F",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC70644F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ZZZ75101Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDS",
            "identifier": "EAP11635F",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC70476F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN PART B",
            "identifier": "CA118859",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, CA

Sources for this page

Verify at the official NPI Registry.