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Allain Edrick Ganchua Francisco, MD

Psychiatry · San Jose

NPI 1316561384

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
16
4 carriers
Offices
5

Offices

5 locations · County of Santa Clara · Alameda Health System · Sutter Bay Medical Foundation

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.

Plans that list them

16 plans · 4 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Francisco’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

16 of 16 plans

Plans whose provider directory lists this clinician
Alignment Health BreathEasy (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Clarity (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Harmony (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)Alignment Health PlanListedOct 3, 2026
Alignment Health Heart & Diabetes Care (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Heart & Diabetes Choice (HMO C-SNP)Alignment Health PlanListedSep 28, 2026
Alignment Health Honor+ Plan (HMO)Alignment Health PlanListedOct 3, 2026
Alignment Health My Choice CalCare (HMO)Alignment Health PlanListedOct 3, 2026
Anthem Full Dual Advantage Aligned (HMO D-SNP)Anthem Blue CrossListedOct 3, 2026
Anthem Medicare Advantage (HMO-POS)Anthem Blue CrossListedOct 3, 2026
Anthem Prime (HMO-POS)Anthem Blue Cross Partnership PlanListedOct 3, 2026
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026

California Medical Board record

Licence A178113 · Current

Licensed to practise in California · since 2022 · expires 2028-06-30 · University of California, San Diego School of Medicine.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%

Original Medicare doctor bills

$9,962

Medicare paid this office $9,962 for 80 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Psychotherapy for crisis, first hour43$4,973$104
Psychiatric diagnostic evaluation with medical services23$3,253$136

Who their Medicare patients are

80 Original Medicare patients in 2024. Average age 50 · Under 65 83% · Women 31% · Health risk score 1.35. Above the middle of the specialty; the typical psychiatry clinician is at 1.35.

Conditions among them: High blood pressure 59% · Depression 41% · Diabetes 19% · COPD 16%.

The office billed $237,085, Medicare allowed $13,605 and paid $9,962; for 99 services of 8 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
20248099501.35$237,085$9,962
202347124531.50$102,268$11,489

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 3 services

Original Medicare services billed in 2023
Psychiatric diagnostic evaluation with medical services29$4,538$130
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes15$4,267$104
Psychotherapy with evaluation and management visit, 30 minutes14$2,201$54

Money from drug and device companies

$125 in 2022

A payment is not proof that care is biased.

Payments by company
Neurocrine BiosciencesIngrezza$125
1 payment
  • Meals for Ingrezza · 2022-01-13 · $125
See the published payment
Every published payment
Neurocrine BiosciencesMeals · 2022-01-13Ingrezza$125

Checkups this office reported

Medicare did not publish checkup rates for this clinician.

Medicare’s overall office score
91.0 / 100
Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.

Professional record

NPI
1316561384
Licence
CA A178113, HI MDR-7919California A178113: Current · expires 2028-06-30
Group
County of Santa Clara · Alameda Health System · Sutter Bay Medical Foundation
Gender
Male
More record details
Sole proprietor
No
Taxonomy
Psychiatry (2084P0800X)
Mailing address
723 Camino Plz # 224, San Bruno, CA, 94066
NPI first listed
2020-06-04
NPI last updated
2025-08-18
NPI record certified
2025-08-15

This is when the NPI record was last certified, not a medical board exam.

Extra NPI addresses: 1356 Lusitana St Fl 4, Honolulu, HI, 96813 · 9990 County Farm Rd, Riverside, CA, 92503 · 1101 Van Ness Ave Ste 1120, San Francisco, CA, 94109