MEDICARE: COUNTY OF SANTA CLARA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	261QU0200X	Urgent Care Clinic/Center
3	261QF0400X	Federally Qualified Health Center (FQHC)	070000085	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CG5995	OTHER	CA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376538991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF SANTA CLARA

Provider Business Mailing Address
First Line	:	PO BOX 103331
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91189-3331
Country	:	US
Telephone Number	:	669-299-8165
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 TULLY RD
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95111-1917
Country	:	US
Telephone Number	:	408-885-5000
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	PAUL E LORENZ
Credential	:
Telephone Number	:	408-885-4010

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	06/04/2025

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Directions to “COUNTY OF SANTA CLARA ” Practice Location

Language	Start Address	Practice Location

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