Organization
GARDNER FAMILY HEALTH NETWORK INC
Active
Organization
GARDNER FAMILY HEALTH NETWORK INC
Active
Other names
ALVISO HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA CORNELL (SUPERVISOR)
(408) 579-6178
Entity
Organization
Contact information
Practice address
1621 GOLD ST., ALVISO, CA 95002-1240
(408) 935-3933
(408) 935-3988
Mailing address
1621 GOLD ST., PO BOX 1240, ALVISO, CA 95002
(408) 935-3933
(408) 935-3988
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
FHC70262F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP11001F
BCEDPALV
CA
01
—
EAP11001F
EAPCALV
CA
05
—
FHC11001F
—
CA
01
—
HAP11001F
SOFPALV
CA
Enumeration date
03/07/2007
Last updated
05/04/2023
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