Organization · Type 2 NPI

County of Santa Clara

Federally Qualified Health Center (FQHC) · San Jose, CA

NPI number 1609580430 Active

Practice location

455 Oconnor Dr Ste 350
San Jose, CA 95128-1646

Call (408) 885-5000 Map

Mailing address

PO Box 103331
Pasadena, CA 91189-3331

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

2 other providers at this address

County of Santa ClaraFederally Qualified Health Center (FQHC) San Jose, CA NPI 1548047863
County of Santa ClaraFederally Qualified Health Center (FQHC) San Jose, CA NPI 1821875931

Other federally qualified health center (fqhc) providers in San Jose

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NPI record

NPI: 1609580430
Entity type: Organization (Type 2)
Issued: Jan 6, 2023
Last updated: Oct 13, 2023
Status: Active
Subpart: Yes of County of Santa Clara

Other names

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Youth Health Center Spark · doing business as
Youth Health Center Spark · doing business as

Authorized official

Paul E Lorenz
Chief Executive Officer
(408) 885-4010

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1609580430

County of Santa Clara's National Provider Identifier is 1609580430, issued on Jan 6, 2023. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in San Jose, CA. The record was last updated on Oct 13, 2023.