Organization
LA CLINICA DE LA RAZA, INC.
Active
Parent organization
LA CLINICA DE LA RAZA, INC.
Other names
San Antonio Neighborhood Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DE LA RAZA, INC.
Authorized official
MS. JANE GARCIA (CHIEF EXECUTIVE OFFICER)
(510) 535-4000
Entity
Organization
Contact information
Practice address
1030 INTERNATIONAL BLVD, OAKLAND, CA 94606-3730
(510) 238-5400
(510) 238-8015
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 238-5400
(510) 238-8015
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
140000708
CA
291U00000X
Clinical Medical Laboratory
CLIA05D0921215
CA
3336C0002X
Clinic Pharmacy
DEA5895240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC11991F
—
CA
Enumeration date
07/23/2006
Last updated
04/06/2022
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