Organization
GARDNER FAMILY HEALTH NETWORK INC
Active
Other names
COMPRECARE HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA CORNELL (CREDENTIALING SUPERVISOR)
(408) 579-6178
Entity
Organization
Contact information
Practice address
3030 ALUM ROCK AVE, SAN JOSE, CA 95127-2807
(408) 935-3933
(408) 935-3988
Mailing address
1621 GOLD ST., PO BOX 1240, ALVISO, CA 92002-1240
(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
—
BCP70262F
BCEDPCCARE
CA
01
—
EAP70262F
EAPCCCARE
CA
05
—
FHC70262F
—
CA
01
—
HAP70262F
SOFPCCARE
CA
Enumeration date
03/06/2007
Last updated
05/04/2023
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