Provider Demographics
NPI:1710105408
Name:AXIS COMMUNITY HEALTH INC
Entity type:Organization
Organization Name:AXIS COMMUNITY HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-462-1755
Mailing Address - Street 1:4361 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6611
Mailing Address - Country:US
Mailing Address - Phone:925-462-1755
Mailing Address - Fax:
Practice Address - Street 1:3311 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-7007
Practice Address - Country:US
Practice Address - Phone:925-447-1881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP70205F261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)