NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Paso Robles, CA
National Provider Identifier
1003462102
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Practice address
2800 Riverside Ave Ste 101
Paso Robles, CA 93446-1312
Phone
(805) 361-8014
Fax
(805) 361-8097
NPI assigned
Aug 14, 2019
Last updated
Sep 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barbara A Allen
Title
Business Office Director
Phone
(805) 361-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2800 Riverside Ave Ste 101
Paso Robles, CA 93446-1312

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8014

Other names 1

  • Community Health Centers Los Robles Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20201208000108 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Paso Robles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003462102. Details of each certification follow.

Federally qualified health center certification: CCN 921902

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
COMMUNITY HEALTH CENTERS LOS ROBLES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 8, 2020
Last certification
Dec 8, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1978 in CA
Enrollment address
2800 Riverside Ave
Ste 101
Paso Robles, CA 93446-1312

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sam Orozco Individual Corporate DirectorBoard Member Oct 14, 2020 5%
Bertha Campos Individual Corporate Director Oct 14, 2020 5%
Lue Thao Individual Corporate OfficerChief Financial Officer Jan 1, 2023 5%
Ronald E Castle Individual Corporate OfficerChief Executive Officer Oct 14, 2020 10%
W-2 Managing EmployeeChief Executive Officer Jul 1, 1978 10%
Barbara a Allen Individual W-2 Managing EmployeeDirector of Business Office Jul 1, 1978 5%
William Gordon Individual Corporate DirectorBoard Member President Oct 14, 2020 5%

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1003462102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8014",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 RIVERSIDE AVE STE 101",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934461312",
            "telephone_number": "805-361-8014",
            "fax_number": "805-361-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Centers Los Robles",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Paso Robles, CA

Sources for this page

Verify at the official NPI Registry.