NPIMap

Organization Active NPI

Tiburcio Vasquez Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hayward, CA
National Provider Identifier
1861860306
Registry record updated Aug 11, 2021
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
28300 Huntwood Ave
Hayward, CA 94544-5425
Phone
(510) 471-5907
NPI assigned
Sep 14, 2015
Last updated
Aug 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

28300 Huntwood Ave
Hayward, CA 94544-5425

Mailing address

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

Other names 1

  • Firehouse Clinic 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
O20160929000825 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 1861860306. Details of each certification follow.

Federally qualified health center certification: CCN 751879

Legal name
TIBURCIO VASQUEZ HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2016
Last certification
Aug 3, 2016
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Aug 26, 1971 in CA
Enrollment address
28300 Huntwood Ave
Hayward, CA 94544-5425

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
Tibucio Vasquez Health Center Inc14 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

1290 B St
Ste 109
Hayward, CA 94541

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

Ownership & related parties

All disclosed owners & managing parties 8

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
Jesse Robles Individual Corporate DirectorBoard Member Jul 11, 2016
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 Operational/Managerial ControlExecutive Asst/Facilities Manage Oct 20, 1991 100%
Jaime Patino Individual Corporate DirectorBoard Member Jul 11, 2016
Nancy Soto Individual Corporate DirectorBoard Member Jul 11, 2016

Practitioners & affiliated clinicians

Practitioners 6

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": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1861860306",
    "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": "28300 HUNTWOOD AVE",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945445425",
            "telephone_number": "510-471-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBURCIO VASQUEZ HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "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": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firehouse Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Firehouse Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.