Provider Demographics
NPI:1417013251
Name:FERTILITY AND REPRODUCTIVE HEALTH INSTITUTE
Entity type:Organization
Organization Name:FERTILITY AND REPRODUCTIVE HEALTH INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DEN RAADT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-402-9219
Mailing Address - Street 1:2581 SAMARITAN DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4113
Mailing Address - Country:US
Mailing Address - Phone:408-356-5000
Mailing Address - Fax:408-356-8954
Practice Address - Street 1:2581 SAMARITAN DR
Practice Address - Street 2:SUITE 306
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4113
Practice Address - Country:US
Practice Address - Phone:408-356-5000
Practice Address - Fax:408-356-8954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory