Organization
LA CLINICA DE LA RAZA, INC.
Active
Parent organization
LA CLINICA DE LA RAZA, INC.
Other names
Casa Del Sol III, Casa del Sol III
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DE LA RAZA, INC.
Authorized official
JANE GARCIA (CHIEF EXECUTIVE OFFICER)
(510) 535-4000
Entity
Organization
Contact information
Practice address
1415-1423 FRUITVALE AVE, OAKLAND, CA 94601-2320
(510) 535-8400
(510) 535-8460
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191
AC BHCS
CA
Enumeration date
11/04/2010
Last updated
02/02/2023
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