Healthcare Provider Details

I. General information

NPI: 1235346040
Provider Name (Legal Business Name): TIBURCIO VASQUEZ HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22211 FOOTHILL BLVD
HAYWARD CA
94541-2712
US

IV. Provider business mailing address

22331 MISSION BLVD
HAYWARD CA
94541-3911
US

V. Phone/Fax

Practice location:
  • Phone: 510-471-5880
  • Fax: 510-782-4678
Mailing address:
  • Phone: 510-471-5907
  • Fax: 510-690-0703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0000001CS
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ANDREA SCHWAB-GALINDO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 510-460-3855