Organization
GARDNER FAMILY HEALTH NETWORK INC
Active
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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