Basic Information
| Provider Information | |||||||||
| NPI: | 1477950681 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SCHOOL HEALTH CLINICS OF SANTA CLARA COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6840 VIA DEL ORO STE 210 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082842280 | ||||||||
| FaxNumber: | 4087540450 | ||||||||
| Practice Location | |||||||||
| Address1: | 6840 VIA DEL ORO STE 210 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082842280 | ||||||||
| FaxNumber: | 4087540450 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2014 | ||||||||
| LastUpdateDate: | 04/11/2018 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | FRANCYNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL BILLER | ||||||||
| AuthorizedOfficialTelephone: | 4082842281 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | 22065 | CA | N | Managed Care Organizations | Health Maintenance Organization | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.