Organization
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Active
Parent organization
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Other names
Indian Health Center of Santa Clara
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Authorized official
DR. ALDON WAYNE SCOTT D.M. (DIRECTOR OF OPERATIONS)
(408) 445-3400
Entity
Organization
Contact information
Practice address
602 E SANTA CLARA ST, SAN JOSE, CA 95112-1908
(408) 445-3400
(408) 448-1727
Mailing address
1333 MERIDIAN AVENUE, SAN JOSE, CA 95125-5212
(408) 445-3400
(408) 448-1727
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
070000482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55-1120
MEDICARE PALMETTO
CA
01
—
FHC11833F
MEDICAL
CA
Enumeration date
09/30/2011
Last updated
11/07/2024
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