Organization
LA CLINICA DE LA RAZA INC
Active
Organization
LA CLINICA DE LA RAZA INC
Active
Other names
TechniClinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE GARCIA (CHIEF EXECUTIVE OFFICER)
(510) 535-4000
Entity
Organization
Contact information
Practice address
4351 BROADWAY, OAKLAND, CA 94611-4612
(510) 879-1907
(510) 879-1999
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)
Primary
550000169
CA
261QS1000X
Student Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-1821
MEDICARE PART A
CA
05
—
FHC71125F
—
CA
01
—
HAP71125F
FPACT
CA
01
—
ZZZ2118Z
MEDICARE PART B
CA
Enumeration date
12/01/2006
Last updated
04/30/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up