SAN JOSE INTEGRATED CLINIC LLC
NPI 1386287753
Nurse Practitioner - Family in San Luis, AZ
About San Jose Integrated Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAN JOSE INTEGRATED CLINIC LLC (NPI 1386287753) is a healthcare organization registered as a family in San Luis, Arizona and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through December 10, 2026 and lists Clarisse Vanessa Nguehanana, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
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 03D1093134
San Jose Integrated Clinic LLC · San Luis, AZFrequently 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 Integrated Clinic LLC's NPI number?
The NPI number for San Jose Integrated Clinic LLC is 1386287753. It was assigned to this organization in the NPPES registry on October 17, 2019.
Where is San Jose Integrated Clinic LLC located?
San Jose Integrated Clinic LLC is located at 2000 E Juan Sanchez Blvd, San Luis, AZ 85336. The listed phone number is (928) 722-6098.
What is San Jose Integrated Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does San Jose Integrated Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D1093134) is associated with this NPI, valid through December 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does San Jose Integrated Clinic LLC accept?
Health plans from Ambetter from Arizona Complete Health list San Jose Integrated Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for San Jose Integrated Clinic LLC was last updated on October 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# San Jose Integrated Clinic Llc · NPI 1386287753
Family organization in San Luis, Arizona. Organization record, active in the CMS NPPES registry since October 17, 2019.
## Identity
- **NPI:** 1386287753 (Entity type: Organization)
- **Enumerated:** October 17, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Clarisse Nguehanana, CEO
## Practice location
- **Address:** 2000 E JUAN SANCHEZ BLVD, San Luis, AZ 85336-0481
- **Phone:** (928) 722-6098 · **Fax:** (928) 627-0007
## Record status
- **NPPES last updated:** October 17, 2019
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1386287753) · Data from the CMS NPPES public registry.