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CH09123AD LA CLINICA DE LA RAZA, INC. (Active)
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Main Details
Name
LA CLINICA DE LA RAZA, INC.
Subdivision Name
TIGER HEALTH CLINIC (aka Fremont High School-Based Clinic)
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006252
340B ID
CH09123AD
Grant Number
H80CS00631
Additional Details
Current Program Status
Active
Registration Date
1/2/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/26/2014
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
La Clinica de La Raza
Jane Garcia, CEO
(510) 535-4000
Primary Contact
La Clinica de La Raza
Dolly Davar, Pharmacy Director
(510) 535-3382
Addresses
Street Address
4610 FOOTHILL BLVD
OAKLAND, CA 94601-4618
Billing Address
La Clinica de La Raza Inc.
P.O. Box 22210
Oakland, CA 94623-2210
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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