NPIMap

Organization Active NPI

East Valley Community Health Center, Inc.

Doing business as East Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
National Provider Identifier
1023134582
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAST VALLEY COMMUNITY HEALTH CENTER, INC.
Doing business as
East Valley Community Health Center
Practice address
420 S Glendora Ave
West Covina, CA 91790-3001
Phone
(626) 919-5724
Fax
(909) 623-9648
NPI assigned
Mar 22, 2007
Last updated
Feb 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Ms. Alicia Mardini
Title
Chief Executive Officer
Phone
(626) 919-4333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

420 S Glendora Ave
West Covina, CA 91790-3001

Mailing address

420 S Glendora Ave
West Covina, CA 91790-3001
Phone (626) 919-4333

Other identifiers 1

IdentifierTypeStateIssuer
EAP12048FMedicaidCA

Other names 1

  • East Valley Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Valley Community Health Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1023134582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "626-919-4333",
            "fax_number": "626-919-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "626-919-5724",
            "fax_number": "909-623-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "MARDINI",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "626-919-4333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EAP12048F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Valley Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.