Healthcare Provider Details

I. General information

NPI: 1114144359
Provider Name (Legal Business Name): AXIS COMMUNITY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 RAILROAD AVE
PLEASANTON CA
94566-6611
US

IV. Provider business mailing address

4361 RAILROAD AVE
PLEASANTON CA
94566-6611
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-1755
  • Fax:
Mailing address:
  • Phone: 925-462-1755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberBCP11593F
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License NumberA0610721
License Number StateCA

VIII. Authorized Official

Name: ELIZABETH PEREZ-HOWE
Title or Position: CEO
Credential:
Phone: 925-462-1755