| NPI | 1154986107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN HART COO/CFO 408-284-2289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 251X00000X |
| 171M00000X Case Manager/Care Coordinator | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2022-02-10 |