Organization
COUNTY OF SANTA CLARA
Active
Other names
Valley Health Center at Puentes Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO F BANUELOS MD (CHIEF MEDICAL OFFICER)
(408) 885-4001
Entity
Organization
Contact information
Practice address
2425 ENBORG LN, VALLEY HEALTH CENTER AT PUENTES CLINIC, SAN JOSE, CA 95128-2648
(408) 885-5000
Mailing address
PO BOX 5280, PATIENT BUSINESS SERVICES, SAN JOSE, CA 95150-5280
(408) 885-5000
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
CA
261QM2800X
Methadone Clinic
—
CA
261QP2300X
Primary Care Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EXE70078F
—
CA
Enumeration date
09/20/2005
Last updated
09/11/2025
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