Healthcare Provider Details

I. General information

NPI: 1528053139
Provider Name (Legal Business Name): COUNTY OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S FAIR OAKS AVE VHC SUNNYVALE
SUNNYVALE CA
94086-7913
US

IV. Provider business mailing address

PO BOX 742502 SCVHHS PATIENT BUSINESS SERVICES
LOS ANGELES CA
90074-2502
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-5000
  • Fax:
Mailing address:
  • Phone: 408-885-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number070000085
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number070000085
License Number StateCA

VIII. Authorized Official

Name: DR. JEFFREY L ARNOLD
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 408-885-4001