COUNTY OF RIVERSIDE (NPI# 1396859179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396859179 |
| Entity Type | Organization |
| Organization Name | COUNTY OF RIVERSIDE |
| Other Organization Name | LAKE ELSINORE FAMILY CARE CENTER |
| Practice Address |
2499 E Lakeshore Dr Lake Elsinore CA 92530-4446 |
| Mailing Address |
Po Box 7849 Riverside CA 92513-7849 |
| Practice Telephone | 9514714200 |
| Practice Fax Number | 9514714205 |
| Mailing Telephone | 9513585222 |
| Mailing Fax Number | 9513585235 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2009-06-12 |
| Authorized Official Name | MRS. KOEN BROWN (DEPUTY DIRECTOR II) |
| Authorized Official Telephone | 9513585222 |
| Authorized Official Credential | RN, MSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251K00000X | Public Health or Welfare | Agencies | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
250000542 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70724F | 05 | |
| CA | CANCER DETECTION PROGRAM | BCP70724F | 01 |
| CA | FAMILY PACT | HAP70724F | 01 |
| Other Name | Type Code |
|---|---|
| LAKE ELSINORE FAMILY CARE CENTER | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821618588 | County of Riverside | Community/Behavioral Health | 63 S 4th St, Banning, CA 92220-4861 | 2020-04-23 |
| 1003436940 | County of Riverside | Community/Behavioral Health | 1225 W Hobsonway, Blythe, CA 92225-1423 | 2020-04-21 |
| 1457971301 | County of Riverside | Community/Behavioral Health | 65753 Pierson Blvd, Desert Hot Springs, CA 92240-3067 | 2020-04-21 |
| 1184244345 | County of Riverside | Community/Behavioral Health | 1283 6th St, Coachella, CA 92236-1707 | 2020-04-17 |
| 1386264562 | County of Riverside | Community/Behavioral Health | 517 Parkridge Ave, Norco, CA 92860-3103 | 2020-04-17 |
| 1942839816 | County of Riverside | Community/Behavioral Health | 91-275 Ave 66, Mecca, CA 92254 | 2020-04-03 |
| 1235768110 | County of Riverside | Community/Behavioral Health | 82675 Us Highway 111, Indio, CA 92201-5635 | 2020-04-03 |
| 1609408178 | County of Riverside | Pharmacy | 26600 Cactus Ave, Moreno Valley, CA 92555-3901 | 2020-02-12 |
| 1982243812 | County of Riverside | Clinic/Center | 26600 Cactus Ave Ste 300, Moreno Valley, CA 92555-3901 | 2019-12-23 |
| 1467943811 | County of Riverside | Community/Behavioral Health | 249 N Spring St, Blythe, CA 92225 | 2018-05-22 |
| Street Address |
2499 E LAKESHORE DR |
| City | LAKE ELSINORE |
| State | CA |
| Zip Code | 92530-4446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790776029 | County of Riverside-community Health Agency | Internal Medicine | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2005-11-04 |
| 1801381132 | Valencia Youkhanna | Psychologist | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4411 | 2018-06-28 |
| 1730625294 | Stephanie Ann Ellis | Social Worker | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2017-01-09 |
| 1578017380 | Kristine Joy Ventura | Registered Nurse | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4411 | 2016-08-09 |
| 1821258922 | Sandar Kyi | Clinic/Center | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2008-06-11 |
| 1952584559 | Sharron Lee Schrenk | Registered Nurse | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2007-12-06 |
| 1831370303 | Iliam Amalia Cisneros | Registered Nurse | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2007-11-26 |
| 1518148576 | Craig Demers | Registered Nurse | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2007-11-19 |
| 1407925209 | Reginald R Peters | Physician Assistant | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2006-11-07 |
| 1033122601 | Michael C Lam | Internal Medicine | 2499 E Lakeshore Dr, Lake Elsinore, CA 92530-4446 | 2006-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801479 | Mercedes Samantha Hamilton | Licensed Psychiatric Technician | 18465 Grand Ave, Lake Elsinore, CA 92530 | 2020-08-17 |
| 1700423779 | Karrene Louise Stanard | Peer Specialist | 31764 Casino Drive, Suite 300, Lake Elsinore, CA 92530 | 2019-12-09 |
| 1972149961 | Danielle Cravalho | Student in an Organized Health Care Education/Training Program | 31964 Mission Trail, Suite B, Lake Elsinore, CA 92530 | 2019-11-25 |
| 1952825648 | R.e. Levi Dental Corporation | Dentist | 32235 Mission Trail # 8, Lake Elsinore, CA 92530 | 2017-08-03 |
| 1144760729 | Alfred Metwashla | Pharmacist | 18269 Collier Ave, Lake Elsinore, CA 92530 | 2017-03-02 |
| 1750788733 | Roxanne Martinez | Case Manager/Care Coordinator | 31764 Casino Drive, Lake Elsinore, CA 92530 | 2014-11-19 |
| 1871870907 | Bryan Tuan Tran | Pharmacist | 160 Diamond Drive, Lake Elsinore, CA 92530 | 2011-11-03 |
| 1043590821 | Katherynn Elizabeth Williams | Marriage & Family Therapist | 600 Central Ave Ste 201, Lake Elsinore, CA 92530 | 2011-08-24 |
| 1861771677 | Judy Kelly | Marriage & Family Therapist | 224 West Graham Ave, Lake Elsinore, CA 92530 | 2011-08-10 |
| 1427343813 | Patrick Chern | Pharmacist | 18287 Collier Ave., Lake Elsinore, CA 92530 | 2011-06-14 |
| Find all providers in zip 92530 | ||||
| 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 |
|---|---|---|---|---|
| 1558925016 | Borrego Community Health Foundation | Clinic/Center | 31739 Riverside Dr Ste A1, Lake Elsinore, CA 92530-7818 | 2019-04-30 |
| 1649662719 | Vista Community Clinic | Clinic/Center | 30195 Fraser Dr, Lake Elsinore, CA 92530-7006 | 2015-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184224156 | Via Care Community Health Center | Clinic/Center | 400 West Washington Blvd., The Hub D3-room 107, Los Angeles, CA 90015 | 2020-10-29 |
| 1821697483 | North East Medical Services | Clinic/Center | 2633 San Bruno Ave, San Francisco, CA 94134-1597 | 2020-10-23 |
| 1508465303 | Valley Health Team, Inc | Clinic/Center | 459 W Line St Ste C, Bishop, CA 93514-3333 | 2020-10-22 |
| 1699373209 | Golden Valley Health Center | Clinic/Center | 1524 Mchenry Ave Ste 550, Modesto, CA 95350-4573 | 2020-10-15 |
| 1508464116 | Golden Valley Health Center | Clinic/Center | 1524 Mchenry Ave Ste 560, Modesto, CA 95350-4573 | 2020-10-15 |
| 1134727746 | Golden Valley Health Center | Clinic/Center | 1524 Mchenry Ave Ste 565, Modesto, CA 95350-4500 | 2020-10-15 |
| 1083221451 | Harmony Health Medical Clinic and Family Resource Center | Clinic/Center | 1930 N. Beale Road, Marysville, CA 95901-6915 | 2020-09-29 |
| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1760098503 | Chicago Clinica Medica Familiar Operated By Neighborhood Healthcare | Clinic/Center | 4022 Chicago Ave Ste A, Riverside, CA 92507-5340 | 2020-09-17 |
| 1164037149 | Camarena Health | Clinic/Center | 16645 Road 26, Madera, CA 93638-0830 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ELSINORE |
| Zip Code | 92530 |
Please comment or provide details below to improve the information on COUNTY OF RIVERSIDE.
| 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.