Organization
ROOSEVELT SCHOOL-BASED BEHAVIORAL HEALTH
Active
Parent organization
LA CLINICA DE LA RAZA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DE LA RAZA, INC.
Authorized official
JANE GARCIA (CEO)
(510) 535-4000
Entity
Organization
Contact information
Practice address
1926 E 19TH ST, OAKLAND, CA 94606-4126
(510) 535-4000
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01QQ1
ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES
CA
Enumeration date
04/19/2017
Last updated
07/21/2022
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