| Hawthorne Elementary School-based Clinic | |
|
1700 28th Ave Oakland CA 94601-2455 | |
| (510) 535-6440 | |
| (510) 436-7490 |
| Full Name | Hawthorne Elementary School-based Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1700 28th Ave, Oakland, California |
| Authorized Official Name and Position | Jane Garcia (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5105354000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Elementary School-based Clinic Po Box 22210 Oakland CA 94623-2210 Ph: (510) 535-4000 | Hawthorne Elementary School-based Clinic 1700 28th Ave Oakland CA 94601-2455 Ph: (510) 535-6440 |
| NPI Number | 1023445780 |
|---|---|
| Provider Enumeration Date | 09/26/2013 |
| Last Update Date | 10/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023445780 | NPI | - | NPPES |
| FHC71087F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
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