SAN JOSE INTEGRATED CLINIC LLC
NPI 1386287753
Nurse Practitioner - Family in San Luis, AZ
- Organization
- Nurse Practitioner
- Family
- Accepts Insurance
- CLIA Number: 03D1093134
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-10-2026
About SAN JOSE INTEGRATED CLINIC LLC
This page provides the complete NPI Profile along with additional information for San Jose Integrated Clinic Llc, a provider established in San Luis, Arizona operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1386287753 assigned on October 2019. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. San Jose Integrated Clinic Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Clarisse Vanessa Nguehanana Fnp (Ceo)
- NPI
- 1386287753 Verify this NPI
- Provider Name
- SAN JOSE INTEGRATED CLINIC LLC
- Entity Type
- Organization
- Location Address
- 2000 E JUAN SANCHEZ BLVD SAN LUIS, AZ 85336
- Location Phone
- (928) 722-6098
- Location Fax
- (928) 627-0007
- Mailing Address
- 2575 W 24TH ST APT 168 YUMA, AZ 85364
- Mailing Phone
- (928) 722-6098
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-17-2019
- Last Update Date
- 10-17-2019
- Code Navigator
A nurse practitioner (NP) like San Jose Integrated Clinic Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D1093134
- Facility Type
- Physician Office
- Certificate Effective Date
- December 11, 2024
- Certificate Expiration Date
- December 10, 2026
- Laboratory Director
- CLARISSE NGUENA-NANA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to San Jose Integrated Clinic Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386287753, enumerated as an "organization" on October 17, 2019.
The provider is located at 2000 E JUAN SANCHEZ BLVD SAN LUIS, AZ 85336 and the phone number is (928) 722-6098.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health. Please consult your insurance carrier or call the provider to verify.
