Provider Demographics
NPI:1689620478
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:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINHEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:408-284-2288
Mailing Address - Street 1:6840 VIA DEL ORO
Mailing Address - Street 2:STE# 210
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119
Mailing Address - Country:US
Mailing Address - Phone:408-284-2280
Mailing Address - Fax:408-754-0450
Practice Address - Street 1:7861 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4604
Practice Address - Country:US
Practice Address - Phone:408-842-1017
Practice Address - Fax:408-842-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X
CA070000696261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71038FOtherMEDI-CAL ID