LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL – NPI #1497090971
Clinic/Center

LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL is an AHC clinic located in MEDFORD, OR. NPPES has assigned the NPI number 1497090971 to LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL on December 10, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL” is a dba name, the actual legal business name for this organization is LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 7 years ago on Jul 15, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL below.

NPI Profile for
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.

NPI Number
1497090971
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC.
Doing Business As (dba): LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL
Primary location
713 SUMMIT AVENUE
MEDFORD, OR 97501
Phone: (541) 842-3771 Fax: (541) 842-3084
Mailing address
931 CHEVY WAY
MEDFORD, OR 97504-4127
Phone: (541) 535-6239 Fax: (541) 842-2212
Organization Subpart
Yes - LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL is subpart of another organization.
Authorized Official
TARA JEANNOT
CHIEF OPERATIONS OFFICER
Phone: (541) 535-6239
Updated
Identifiers

Identifiers for LA CLINICA SCHOOL- BASED HEALTH CENTER AT JACKSON SCHOOL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDOR022868
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
OR

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.