institution
La Clinica De La Raza Inc
Mental Health Clinic/Center (Including Community Mental Health Center) in Oakland, California
NPI 1174639116

La Clinica De La Raza Inc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Oakland, CA and is specialized in Mental Health (Including Community Mental Health Center). La Clinica De La Raza Inc practices in Oakland, CA. The NPI Number for La Clinica De La Raza Inc is 1174639116 and holds a License No. 140000171 (California).

The current practice location address for La Clinica De La Raza Inc is 1501 Fruitvale Ave, Oakland, CA and can be reached out via phone at 510-535-6200.

Location: 1501 Fruitvale Ave, Oakland, CA, 94623-2210
institution
Provider Profile Details
NPI Number
1174639116
Provider Name
La Clinica De La Raza Inc
Credential
Provider Entity Type
Organization
Address
1501 Fruitvale Ave, Oakland, CA, 94623-2210
Phone Number
510-535-6200
Fax Number
Provider Enumeration Date
08/22/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ29799Z 01 CA MEDICARE PART B
05-1063 01 CA MEDICARE PART A
FHC80040F 05 CA
institution
Provider Business Practice Location Address Details
Address
1501 Fruitvale Ave
City
State
Zip
94601-2322
Phone Number
510-535-6200
Fax Number
person
Provider Business Mailing Address Details
Address
1501 Fruitvale Ave
City
State
Zip
94601-2322
Phone Number
510-535-6200
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
140000171 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
140000171 (California)
Definition
Definition to come...
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