FAMILY HEALTH CENTERS OF SAN DIEGO, INC. (NPI# 1104480946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104480946 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SAN DIEGO, INC. |
| Other Organization Name | FHCSD-HEALTH HOMES |
| Practice Address |
5160 Federal Blvd San Diego CA 92105-5429 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6195152300 |
| Practice Fax Number | 6192371856 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6192371856 |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-29 |
| Authorized Official Name | RICARDO ROMAN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6199064603 |
| Is Organization Subpart | Y |
| Parent Organization Name | FAMILY HEALTH CENTERS OF SAN DIEGO, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Other Name | Type Code |
|---|---|
| FHCSD-Health Homes | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164671749 | Family Health Centers of San Diego, Inc. | Clinic/Center | 2130 National Ave, San Diego, CA 92113-2209 | 2008-09-18 |
| 1700440781 | Family Health Centers of San Diego, Inc. | Clinic/Center | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-04-25 |
| 1619531696 | Family Health Centers of San Diego, Inc. | Clinic/Center | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-04-25 |
| 1437678364 | Family Health Centers of San Diego, Inc. | Clinic/Center | 2130 National Ave, San Diego, CA 92113-2209 | 2017-09-12 |
| 1184169963 | Family Health Centers of San Diego, Inc. | Clinic/Center | 3514 30th St, San Diego, CA 92104-4120 | 2017-01-03 |
| 1417409228 | Family Health Centers of San Diego, Inc. | Clinic/Center | 1000 Euclid Ave, National City, CA 91950-3856 | 2016-10-27 |
| 1497204234 | Family Health Centers of San Diego, Inc. | Clinic/Center | 8851 Center Dr, Ste 312, La Mesa, CA 91942-3017 | 2016-09-21 |
| 1669827598 | Family Health Centers of San Diego, Inc. | Clinic/Center | 4065 3rd Ave, San Diego, CA 92103-2184 | 2016-04-28 |
| 1932561198 | Family Health Centers of San Diego, Inc. | Clinic/Center | 525 E Main St, El Cajon, CA 92020-4007 | 2016-03-25 |
| 1336332725 | Family Health Centers of San Diego, Inc. | Clinic/Center | 1809 National Ave, San Diego, CA 92113-2113 | 2007-08-20 |
| Street Address |
5160 FEDERAL BLVD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619210614 | Julie Phuong Thao Lu | Family Medicine | 5160 Federal Blvd, San Diego, CA 92105-5429 | 2013-03-28 |
| 1336525906 | Family Health Centers of San Diego Inc | Clinic/Center | 5160 Federal Blvd, San Diego, CA 92105-5429 | 2015-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1770105439 | Timothy Mccloud | Case Manager/Care Coordinator | 6160 Mission Gorge Rd # 108, San Diego, CA 92120-3410 | 2020-05-15 |
| 1043846272 | Daniel Rafael Martinez | Case Manager/Care Coordinator | 8825 Aero Dr Ste 305, San Diego, CA 92123-2270 | 2020-03-19 |
| 1043844376 | Ariel A Anderson | Case Manager/Care Coordinator | 8501 Larkdale Ave, San Diego, CA 92123-2047 | 2020-02-25 |
| 1124664818 | Sarah Milan | Case Manager/Care Coordinator | 1846 30th St Apt A, San Diego, CA 92102-1145 | 2019-11-18 |
| 1750930814 | Christine Guianne Mupas Ramos | Case Manager/Care Coordinator | 1660 Hotel Cir N # 320, San Diego, CA 92108-2807 | 2019-09-10 |
| 1437708518 | Brendan Domingo Guerra | Case Manager/Care Coordinator | 5617 Vista San Juanico, San Diego, CA 92154-5672 | 2019-09-10 |
| 1457912982 | Kendra Crater | Case Manager/Care Coordinator | 3481 Kurtz St, San Diego, CA 92110-4430 | 2019-06-25 |
| 1790342319 | Ariella Beth Darlington | Case Manager/Care Coordinator | 3644 Princeton Ave, San Diego, CA 92117-5637 | 2019-05-20 |
| 1013572361 | Brandon Joel Jessie | Case Manager/Care Coordinator | 1250 Morena Blvd Bldg 2nd, San Diego, CA 92110-3815 | 2019-05-02 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.