San Diego American Indian Health Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SAN DIEGO AMERICAN INDIAN HEALTH CENTER

Doing business as

San Diego Community Health Center

Practice address

2630 1St Ave
San Diego, CA 92103-6599

Phone

(619) 234-2158

Fax

(619) 234-0206

NPI assigned

Oct 5, 2006

Last updated

Nov 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tami Bereki

Title

Cfo

Phone

(909) 921-3808

Specialties & licenses 14

Addresses

Other identifiers 4

Other names 1

• San Diego Community Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003902917. Details of each certification follow.

• CCN 551041 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 551041

Legal name

SAN DIEGO AMERICAN INDIAN HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 18, 2010

Last certification

Aug 18, 2010

Ownership / control type

Non-profit – church related

Organization structure

CorporationNon-profit

Enrollment address

2630 1St Ave
San Diego, CA 92103

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFGCCD

All disclosed owners & managing parties 11

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Steven Edward Gardner, M.D.

  • Infectious Disease Physician
  • San Diego, CA
  • NPI 1295731990

  Corporate Director

  CMS ownership
• Keren Arkin Hilger, MD

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1891923462

  Corporate Director

  CMS ownership

Practitioners 56

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.

• Chevon Alderson, MD

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1396124145
  Medicare reassignment Care Compare group NPD
• Ann Marie Correa

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1083420814
  Medicare reassignment Care Compare group NPD
• Catherine Nkechi Ajala-Staats, NP

  • Family Nurse Practitioner
  • El Cajon, CA
  • NPI 1376053413
  Medicare reassignment NPD
• Shirin Alonzo, MD, MPH

  • Internal Medicine Physician
  • Beverly Hills, CA
  • NPI 1225318041
  Medicare reassignment NPD
• Shaun Michael Austin, M.D.

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1801024393
  Medicare reassignment NPD
• Jonathan Louis Baker, M.D.

  • Family Medicine Physician
  • Alpine, CA
  • NPI 1184954455
  Medicare reassignment NPD
• Kathryn Callaghan, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1558768812
  Medicare reassignment NPD
• Rhoda Carino Diokno, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1629109483

  Mental Health

  Medicare reassignment NPD
• Ammar Charestan, M.D.

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1295181543
  Medicare reassignment NPD
• Harjot Singh Chawla, D.D.S.

  • Pediatric Dentistry
  • San Diego, CA
  • NPI 1659662757
  Medicare reassignment NPD
• Max Chen, M.D.

  • Internal Medicine Physician
  • Vista, CA
  • NPI 1285750356
  Medicare reassignment NPD
• Luis Fidel Clement, PSY.D.

  • Clinical Psychologist
  • Valley Center, CA
  • NPI 1235364712
  Medicare reassignment NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762473600000",
    "number": "1003902917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-234-2158",
            "fax_number": "619-234-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 1ST AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921036599",
            "telephone_number": "619-234-2158",
            "fax_number": "619-234-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO AMERICAN INDIAN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A",
        "authorized_official_last_name": "BEREKI",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "909-921-3808",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20936",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS17413",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57514",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58278",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G23820A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78887",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A107921",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP70019F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70019F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EAPC70019F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP70019F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Diego Advanced Surgery P.C.
• San Diego Air Support Inc
• San Diego Ambulance LLC (San Diego Ambulance Services)
• San Diego Ambulatory Surgery Center
• San Diego Ambulatory Surgery Center LLC
• San Diego American Indian Health Center (SDAIHC Mobile Unit 3)
• San Diego American Indian Health Center (San Diego Community Health Center)
• San Diego and Orange County Lasik Institute
• San Diego Anesthesia Consultants
• San Diego Anesthesia LLC

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.