EAST VALLEY COMMUNITY HEALTH CENTER, INC. (NPI# 1386912202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386912202 |
| Entity Type | Organization |
| Organization Name | EAST VALLEY COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
17840 Villa Corta St La Puente CA 91744-5342 |
| Mailing Address |
420 S Glendora Ave West Covina CA 91790-3001 |
| Practice Telephone | 6269194333 |
| Practice Fax Number | 6269192084 |
| Mailing Telephone | 6269194333 |
| Mailing Fax Number | 6269192084 |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2014-05-28 |
| Authorized Official Name | MS. ALICIA MARDINI (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6269194333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550002062 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA DEPARTMENT OF PUBLIC HEALTH LICENSE | 550002062 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193320 | East Valley Community Health Center, Inc. | Clinic/Center | 1400 E Mission Blvd, Pomona, CA 91766-2229 | 2020-04-23 |
| 1861983470 | East Valley Community Health Center, Inc. | Clinic/Center | 17800 Renault St, La Puente, CA 91744-5333 | 2018-05-21 |
| 1285046847 | East Valley Community Health Center, Inc. | Clinic/Center | 276 West College Street, Covina, CA 91723-1902 | 2014-05-29 |
| 1518587435 | East Valley Community Health Center, Inc. | Clinic/Center | 4368 Santa Anita Ave, El Monte, CA 91731-1606 | 2020-04-21 |
| 1598007197 | East Valley Community Health Center, Inc. | Clinic/Center | 14101 Nelson Ave, La Puente, CA 91746-2640 | 2013-03-21 |
| 1972844272 | East Valley Community Health Center, Inc. | Clinic/Center | 831 E Arrow Hwy, Pomona, CA 91767-2535 | 2013-03-12 |
| 1952427411 | East Valley Community Health Center, Inc. | Clinic/Center | 420 S Glendora Ave, West Covina, CA 91790-3001 | 2007-03-22 |
| 1700902251 | East Valley Community Health Center, Inc. | Clinic/Center | 1555 S Garey Ave, Pomona, CA 91766-5222 | 2007-03-22 |
| 1619093168 | East Valley Community Health Center, Inc. | Clinic/Center | 1555 S Garey Ave, Pomona, CA 91766-5222 | 2007-03-22 |
| 1023134582 | East Valley Community Health Center, Inc. | Clinic/Center | 420 S Glendora Ave, West Covina, CA 91790-3001 | 2007-03-22 |
| Street Address |
17840 VILLA CORTA ST |
| City | LA PUENTE |
| State | CA |
| Zip Code | 91744-5342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073158051 | Juan Gomez Jr. | Case Manager/Care Coordinator | 106 S. Seventh Avenue, La Puente, CA 91744 | 2019-11-13 |
| 1821630898 | Richard B Vasquez Jr. | Technician | 14602 Hartsville St., La Puente, CA 91744 | 2019-10-11 |
| 1639720196 | Yolanda Salazar | Technician | 14744 Flanner Street, La Puente, CA 91744 | 2019-09-26 |
| 1154898245 | Karen Elvera Garza | Case Manager/Care Coordinator | 160 S.seventh Ave, La Puente, CA 91744 | 2018-10-27 |
| 1649709916 | Briana Michelle Ramos | Student in an Organized Health Care Education/Training Program | 1550 N Hacienda Blvd., La Puente, CA 91744 | 2017-06-08 |
| 1952857237 | Autumn Abadesco | Dentist | 525 N Azusa Ave #112, La Puente, CA 91744 | 2016-08-28 |
| 1649724790 | Michelle Han | Acupuncturist | 129 Homestead St, La Puente, CA 91744 | 2016-08-06 |
| 1750756375 | Vanessa Molina | Marriage & Family Therapist | 160 S. Seventh Ave., La Puente, CA 91744 | 2015-12-08 |
| 1649668294 | Jennifer Mendoza Leyran | Physical Therapist | 15959 Main Street, La Puente, CA 91744 | 2015-01-06 |
| 1073949863 | Brenda Ann Tabone | Nurse Practitioner | 160 S. Seventh Avenue, La Puente, CA 91744 | 2013-09-25 |
| Find all providers in zip 91744 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861983470 | East Valley Community Health Center, Inc. | Clinic/Center | 17800 Renault St, La Puente, CA 91744-5333 | 2018-05-21 |
| 1598007197 | East Valley Community Health Center, Inc. | Clinic/Center | 14101 Nelson Ave, La Puente, CA 91746-2640 | 2013-03-21 |
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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.