LIVINGSTON COMMUNITY HEALTH (NPI# 1528433588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528433588 |
| Entity Type | Organization |
| Organization Name | LIVINGSTON COMMUNITY HEALTH |
| Other Organization Name | BENTLEY HEALTH CENTER |
| Practice Address |
12619 Bentley St Waterford CA 95386-9011 |
| Mailing Address |
1140 Main St Livingston CA 95334-1257 |
| Practice Telephone | 2094426200 |
| Practice Fax Number | 2093949093 |
| Mailing Telephone | 2093947913 |
| Mailing Fax Number | 2093943660 |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2017-08-01 |
| Authorized Official Name | MRS. LESLIE MCGOWAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2093947913 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | Y |
| Parent Organization Name | LIVINGSTON COMMUNITY HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE OSCAR/CERTIFICATION | 751901 | 01 |
| Other Name | Type Code |
|---|---|
| Bentley Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073175675 | Livingston Community Health | Pharmacy | 600 B St Ste B, Livingston, CA 95334-9593 | 2019-07-03 |
| 1245721539 | Livingston Community Health | Clinic/Center | 600 B Street, Suite A, B, C, Livingston, CA 95334-1257 | 2018-05-23 |
| 1730530254 | Livingston Community Health | Clinic/Center | 16233 King St, Delhi, CA 95315 | 2016-06-27 |
| 1295184117 | Livingston Community Health | Clinic/Center | 1010 W Las Palmas Ave Ste E, Patterson, CA 95363-8873 | 2016-06-10 |
| 1508408550 | Livingston Community Health | Clinic/Center | 2412 3rd St, Hughson, CA 95326-9310 | 2019-10-10 |
| 1023650066 | Livingston Community Health | Clinic/Center | 800 Delbon Ave, Turlock, CA 95382-2022 | 2019-10-10 |
| 1487012779 | Livingston Community Health | Clinic/Center | 1617 Main St, Livingston, CA 95334-1250 | 2016-02-02 |
| 1124300207 | Livingston Community Health | Clinic/Center | 7970 Lander Ave, Suite A, Hilmar, CA 95324-8310 | 2011-09-14 |
| 1427110329 | Livingston Community Health | Clinic/Center | 1140 Main St, Livingston, CA 95334-1257 | 2006-12-15 |
| Street Address |
12619 BENTLEY ST |
| City | WATERFORD |
| State | CA |
| Zip Code | 95386-9011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366857658 | Diana Hollingshead-parker | Registered Nurse | 421 Tim Bell Rd, Waterford, CA 95386 | 2014-06-25 |
| 1497817407 | James Yamamoto | Dentist | 12142 Yosemite Blvd, Waterford, CA 95386 | 2006-12-15 |
| 1588664684 | Don Michael Endress | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2005-07-29 |
| 1649527664 | Eric Gust Benson | Registered Nurse | 12700 Welch St, Waterford, CA 95386-8765 | 2012-08-08 |
| 1326106501 | Don Michael Endress M.d. | General Practice | 12700 Welch St, Waterford, CA 95386-8765 | 2006-12-04 |
| 1356686992 | Kimberlie Ann Payne | Occupational Therapy Assistant | 13209 Fountain Dr, Waterford, CA 95386-8858 | 2012-12-08 |
| 1518423631 | Gill Pharmacy Inc | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2019-02-13 |
| 1639709520 | Ravi Gandhi | Pharmacy | 12648 Bentley St, Waterford, CA 95386-9009 | 2020-01-20 |
| 1336176122 | Maximilian A. Schanderl | Pharmacist | 12641 Bentley St, Waterford, CA 95386-9011 | 2006-06-27 |
| 1518992031 | Tower Pharmacy, Inc. | Pharmacy | 12641 Bentley St, Waterford, CA 95386-9011 | 2006-07-12 |
| Find all providers in zip 95386 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1982131967 | Oakland Integrated Healthcare Network | Clinic/Center | 501 N Cass Lake Rd, Waterford, MI 48328-2307 | 2017-05-22 |
| 1124381793 | Oakland Integrated Healthcare Network | Clinic/Center | 279 Summit Drive, Waterford, MI 48328-1601 | 2012-06-19 |
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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.