LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. NPI 1851327571

NPI Information

NPI: 1851327571
Provider Name: LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.

Doing Business As: PHOENIX HEALTH CENTER- LA CLINICA

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3617 S PACIFIC HWY
MEDFORD, OR
ZIP 97501
Phone: (541) 535-6239
Get Directions

LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. is a federally qualified health center (fqhc) clinic center in Medford, OR. LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC. NPI is 1851327571. The provider is registered as an organization entity type.
The provider Is Doing Business As Phoenix Health Center- La Clinica.

The provider's business location address is:

3617 S PACIFIC HWY
MEDFORD, OR
ZIP 97501
Phone: (541) 535-6239
Fax: (541) 512-1026

The provider's authorized official is Tara Lynette Jeannot .
The authorized official title is Chief Operations Officer and has the following contact phone number (541) 535-6239.

The CLIA number assigned to this NPI record is 38D0628059 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/24/2006 and was last updated on 7/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	022868	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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