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	261QF0050X	Non-Surgical Family Planning Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1053026898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF SANTA CLARA

Provider Business Mailing Address
First Line	:	751 S BASCOM AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2604
Country	:	US
Telephone Number	:	408-885-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 E SANTA CLARA ST STE 300
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-1938
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	:	01/17/2023
Last Update Date	:	01/17/2023

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Directions to “COUNTY OF SANTA CLARA ” Practice Location

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