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INDIAN HEALTH CENTER OF SANTA CLARA VALLEY - FAMILY MEDICINE CENTER
NPI 1114290780
Clinic/Center - Federally Qualified Health Center (FQHC) in San Jose, CA

Active since February 13, 2012CLIA Certified · 5 labs
455 OCONNOR DR STE 200, SAN JOSE, CA 95128(408) 445-3400(408) 448-1727 Get Directions Write a Review

NPPES record last updated: February 7, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Indian Health Center Of Santa Clara Valley - Family Medicine Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INDIAN HEALTH CENTER OF SANTA CLARA VALLEY - FAMILY MEDICINE CENTER (NPI 1114290780) is a healthcare organization registered as a federally qualified health center (fqhc) in San Jose, California and active in the NPI registry since February 2012. The organization holds 5 active CLIA laboratory certificates and lists Aldon Wayne Scott, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1114290780
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameINDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Location Address455 OCONNOR DR STE 200San Jose, CA 95128-1632
Mailing Address1333 Meridian AveSan Jose, CA 95125-5212 · (408) 445-3400 · Fax (408) 448-1727
Phone(408) 445-3400
Fax(408) 448-1727
Organization SubpartYes
Authorized OfficialAldon Wayne ScottDirector Of Operations · (408) 445-3400
Enumeration DateFebruary 13, 2012
Last NPPES UpdateFebruary 7, 2013
✔ NPI 1114290780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in CA · 550001941
455 OCONNOR DR STE 200, San Jose, CA 95128
Open in Google Maps ↗

Other Names 1

Other NameIndian Health Center Of Santa Clara Valley - Family Medicine Center

Other Identifiers 5

Other55-1137CA · Medicare Palmetto
Medicare PIN051979CA
MedicaidFHC11833FCA
OtherG01133-01CA · Delta Dental
OtherFHC11833FCA · State Programs

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2040417

Indian Health Center Of Santa Clara Valley · San Jose, CA
Active · expires Apr 29, 2028
CLIA Number05D2040417
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateApril 30, 2026
Certificate Expiration DateApril 29, 2028
Laboratory DirectorElizabeth Mccraven
Laboratory Phone(408) 445-3400
Laboratory LocationIndian Health Center Of Santa Clara Valley1333 Meridian Ave, San Jose, CA 95125
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2302460

Indian Health Center Of Santa Clara Valley · San Jose, CA
Active · expires Apr 9, 2028
CLIA Number05D2302460
Laboratory TypeMobile Laboratory
Certificate Effective DateApril 10, 2026
Certificate Expiration DateApril 9, 2028
Laboratory DirectorElizabeth Mccraven
Laboratory Phone(408) 445-3400
Laboratory LocationIndian Health Center Of Santa Clara Valley1333 Meridian Ave, San Jose, CA 95125
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0607474

Indian Hlth Ctr Of Santa Clara Valley Inc · San Jose, CA
Active · expires Aug 31, 2026
CLIA Number05D0607474
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRia Paul
Laboratory Phone(408) 445-3400
Laboratory LocationIndian Hlth Ctr Of Santa Clara Valley Inc1333 Meridian Ave, San Jose, CA 95125
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2100039

Indian Health Center Of Santa Clara Valley · San Jose, CA
Active · expires Aug 5, 2027
CLIA Number05D2100039
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 6, 2025
Certificate Expiration DateAugust 5, 2027
Laboratory DirectorElizabeth Mccraven
Laboratory Phone(408) 445-3400
Laboratory LocationIndian Health Center Of Santa Clara Valley2039 Forest Ave Ste 105, San Jose, CA 95128
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2042379

Indian Health Center Of Santa Clara Valley · San Jose, CA
Active · expires Apr 12, 2027
CLIA Number05D2042379
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 13, 2025
Certificate Expiration DateApril 12, 2027
Laboratory DirectorElizabeth Mccraven
Laboratory Phone(408) 445-3400
Laboratory LocationIndian Health Center Of Santa Clara Valley455 O'connor Dr Ste 200, San Jose, CA 95128
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BERNADETTE TERESA ANSOLABEHERE MD
Family Medicine
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 283-7676
MARGARETTE JEANNETTE SHEGOG MD
Family Medicine
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (888) 924-1036
DR. BIANCA LYNN BUSTAMENTE DO
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (818) 274-2570
CECILIA ZHOU
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 283-7666
ENOCH YOON M.D.
Family Medicine
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 283-7676
MILTON BIRD MCCOLL M.D.
General Practice
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 283-7676
MARY JULIA TUROCY
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 283-7676
DR. JONATHAN HSIJING LU MD, MS
Student in an Organized Health Care Education/Training Program
455 OCONNOR DR STE 200
SAN JOSE, CA 95128
Santa Clara County (408) 445-3400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Indian Health Center Of Santa Clara Valley's NPI number?

The NPI number for Indian Health Center Of Santa Clara Valley is 1114290780. It was assigned to this organization in the NPPES registry on February 13, 2012. The provider is also known as Indian Health Center Of Santa Clara Valley - Family Medicine Center.

Where is Indian Health Center Of Santa Clara Valley located?

Indian Health Center Of Santa Clara Valley is located at 455 Oconnor Dr Ste 200, San Jose, CA 95128. The listed phone number is (408) 445-3400.

What is Indian Health Center Of Santa Clara Valley's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Indian Health Center Of Santa Clara Valley hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Indian Health Center Of Santa Clara Valley was last updated on February 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.