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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