Roosevelt Health Center

LBN: La Clinica De La Raza, Inc.
Roosevelt Health Center is an health care organization with primary practice located at 1926 - 19Th Avenue , Oakland CA 94606-4126. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Student Health. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. La Clinica De La Raza, Inc. can be contacted via phone (510) 879-2953, or through Garcia, Jane via phone (510) 535-4000.

Contact Information

Primary practice address
1926 - 19Th Avenue Oakland CA 94606-4126
Phone: (510) 879-2953
Fax: (510) 879-2956
Website:
Map and Directions
Authorized official contact:
Name: Garcia, Jane
Phone: (510) 535-4000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 550000036 California
Ambulatory Health Care Facilities / Student Health 261QS1000X

Profile Details

NPI number 1851522015
LBN Legal business name La Clinica De La Raza, Inc.
DBA Doing business as Roosevelt Health Center
Authorized official Garcia, Jane
Entity Organization
Organization subpart 1 No
Enumeration date Aug 5th, 2009
Last updated Oct 17th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851522015 NPPES
California MEDICAID 1851522015
California Other 1851522015

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