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General NPI Number Information
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NPI Number | 1073676243
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Entity Type | Organization
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Legal Business Name | TIBURCIO VASQUEZ HEALTH CENTER, INC.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 04/04/2022
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Provider Practice Location Address
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Address Line | 22331 MISSION BLVD
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City | HAYWARD
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State | CA
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Zip | 94541
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Country | US
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Telephone | 510-471-5880
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Fax | 510-690-0703
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Provider Business Mailing Address
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Address Line | 22331 MISSION BLVD
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City | HAYWARD
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State | CA
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Zip | 94541
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Country | US
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Telephone | 510-471-5880
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Fax | 510-690-0703
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANDREA SCHWAB-GALINDO
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Credential |
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Telephone | 510-460-3855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 140000705
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License Number State | CA
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