Provider Demographics
NPI:1154986107
Name:SCHOOL HEALTH CLINICS OF SANTA CLARA COUNTY
Entity type:Organization
Organization Name:SCHOOL HEALTH CLINICS OF SANTA CLARA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-284-2289
Mailing Address - Street 1:6840 VIA DEL ORO STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1372
Mailing Address - Country:US
Mailing Address - Phone:408-284-2289
Mailing Address - Fax:
Practice Address - Street 1:855 LENZEN AVE RM 105
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2736
Practice Address - Country:US
Practice Address - Phone:408-525-4729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty