| NPI | 1326335464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCRESHIA RENTERIA Authorized Official 707-964-1251 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2019-10-28 |