Organization
LA CLINICA DE LA RAZA INC
Active
Other names
La Clinica Vallejo Great Beginnings
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANE GARCIA (CHIEF EXECUTIVE OFFICER)
(510) 535-2915
Entity
Organization
Contact information
Practice address
210 HOSPITAL DR, VALLEJO, CA 94589-2517
(707) 645-7316
(707) 645-0426
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550000257
CA
291U00000X
Clinical Medical Laboratory
05D1057049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC71149F
—
CA
Enumeration date
12/04/2006
Last updated
10/17/2019
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