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Organization

SAN BENITO HEALTH FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSA VIVIAN FERNANDEZ MPH (EXECUTIVE DIRECTOR)
(831) 637-5306
Entity
Organization

Contact information

Practice address
351 FELICE DR, HOLLISTER, CA 95023-3361
(831) 637-5306
(831) 637-9640
Mailing address
351 FELICE DR, HOLLISTER, CA 95023-3361
(831) 637-5306
(831) 637-9640

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
BCP03872F
CA
01
EAP03872F
UNCOMPENSATED CARE
CA
01
FHC03872F
MEDI-CAL IDENTIFIER
CA
05
HAP03872F
CA
Enumeration date
10/26/2006
Last updated
08/22/2020
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