1. Home
  2. Directory
  3. California
  4. Hawthorne
  5. Clinic Center
  6. NPI Profile

SAN JOSE COMMUNITY CLINIC
NPI 1285751024
Clinic/Center in Hawthorne, CA

Active since March 25, 2007CLIA 05D1018353 · Waiver
11950 INGLEWOOD AVE, HAWTHORNE, CA 90250(310) 349-8338(310) 349-8340 Get Directions Write a Review

NPPES record last updated: June 18, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About San Jose Community Clinic NPPES

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

SAN JOSE COMMUNITY CLINIC (NPI 1285751024) is a healthcare organization registered as a clinic/center in Hawthorne, California and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through October 19, 2027 and lists Reza Danesh, Ceo, as its authorized official.

NPPES Registry Identity

NPI1285751024
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSAN JOSE COMMUNITY CLINIC
Location Address11950 INGLEWOOD AVEHawthorne, CA 90250
Mailing AddressPo Box 903Palos Verdes Estates, CA 90274-0903 · (310) 349-8338 · Fax (310) 349-8340
Phone(310) 349-8338
Fax(310) 349-8340
Organization SubpartNo
Authorized OfficialReza DaneshCeo · (310) 349-8338
Enumeration DateMarch 25, 2007
Last NPPES UpdateJune 18, 2018
✔ NPI 1285751024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in CA · A055334
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
11950 INGLEWOOD AVE, Hawthorne, CA 90250
Open in Google Maps ↗

Other Identifiers 1

Medicaid00A553341CA

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 05D1018353

San Jose Community Clinic · Hawthorne, CA
Active · expires Oct 19, 2027
CLIA Number05D1018353
Laboratory TypePhysician Office
Certificate Effective DateOctober 20, 2025
Certificate Expiration DateOctober 19, 2027
Laboratory DirectorReza Danesh MD
Laboratory Phone(310) 349-8338
Laboratory LocationSan Jose Community Clinic11950 Inglewood Ave, Hawthorne, CA 90250
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 San Jose Community Clinic's NPI number?

The NPI number for San Jose Community Clinic is 1285751024. It was assigned to this organization in the NPPES registry on March 25, 2007.

Where is San Jose Community Clinic located?

San Jose Community Clinic is located at 11950 Inglewood Ave, Hawthorne, CA 90250. The listed phone number is (310) 349-8338.

What is San Jose Community Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does San Jose Community Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1018353) is associated with this NPI, valid through October 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Jose Community Clinic was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.