NPIMap

Organization Active NPI

Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
National Provider Identifier
1053875484
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTHCARE NETWORK
Practice address
65 N. Hockett St.
Porterville, CA 93257
Phone
(559) 737-4700
Fax
(559) 734-1247
NPI assigned
Jan 30, 2019
Last updated
Oct 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Kerry Lynn Hydash
Title
President & Ceo
Phone
(559) 737-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

65 N. Hockett St.
Porterville, CA 93257

Mailing address

305 E Center Ave
Visalia, CA 93291-6331
Phone (559) 737-4700

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040123000681 CA Part B Supplier - Clinic/Group Practice 6305756339 Receives reassigned benefits from 429 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reedley, CA; Ivanhoe, CA; Selma, CA; Springville, CA; Squaw Valley, CA; Strathmore, CA; Terra Bella, CA; Three Rivers, CA…
O20191010002963 CA Part A Provider - Federally Qualified Health Center (FQHC) 6305756339 Practice locations: Porterville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053875484. Details of each certification follow.

Federally qualified health center certification: CCN 921179

Legal name
FAMILY HEALTHCARE NETWORK
Doing business as
FAMILY HEALTHCARE NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2019
Last certification
Oct 2, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 29, 1978 in CA
Enrollment address
65 N Hockett St
Porterville, CA 93257-4700

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kerry Hydash Individual Corporate OfficerPresident & Ceo Apr 23, 2013 100%
Corporate DirectorPresident & Ceo Apr 23, 2013 100%
W-2 Managing EmployeePresident & Ceo Apr 23, 2013 100%
Vivian del Toro Individual Corporate Director Jul 1, 2023
Chad Vawter Individual Corporate OfficerDeputy Ceo Apr 23, 2013
Michael Botello Individual Corporate DirectorBoard Member Mar 18, 2006
Olivia Gamboa Individual Corporate DirectorBoard Member Feb 15, 2002
Teresa de la Rosa Individual Corporate DirectorBoard Member Jul 1, 2009
John Zapalac Individual Corporate DirectorBoard Member Dec 19, 2007
Minnetta Costa Individual Corporate DirectorBoard Member Nov 16, 2011
Family Healthcare Network Organization, Visalia, CA Non-profit 5% Or Greater Direct Ownership Interest Apr 29, 2019 100%
Maria Gonzalez Individual Corporate DirectorBoard Member Mar 15, 1998
Michelle Cano-Dewees Individual Corporate DirectorBoard Member Mar 1, 2016
Sandra Miller Individual Corporate DirectorBoard Member Oct 1, 2014

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Healthcare NetworkTulare, CA, CCN 751184 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 1978
Family Healthcare NetworkPixley, CA, CCN 751935 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 29, 2019
Family Healthcare NetworkStrathmore, CA, CCN 921099 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 1978
Family Healthcare NetworkDinuba, CA, CCN 921118 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 1978
Family Healthcare NetworkFresno, CA, CCN 921087 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 1978
Family Healthcare NetworkTulare, CA, CCN 921138 Federally qualified health center Operational/Managerial Control (100%) Jun 29, 1978
Family Healthcare NetworkVisalia, CA, CCN 921163 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 7, 2019
Family Healthcare NetworkSelma, CA, CCN 921849 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 20, 2020
Family Healthcare NetworkSquaw Valley, CA, CCN 921846 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 23, 2019
Family Healthcare NetworkFarmersville, CA, CCN 921864 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2019
Family Healthcare NetworkExeter, CA, CCN 921870 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 9, 2019
Family Healthcare NetworkReedley, CA, CCN 921847 Federally qualified health center Operational/Managerial Control (100%) Sep 16, 2019
Family Healthcare NetworkDelano, CA, CCN A01914 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2013
Mar 1, 2024
Family Healthcare NetworkHanford, CA, CCN A01983 Federally qualified health center Operational/Managerial Control (100%) Jan 30, 2024

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1053875484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-734-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N. HOCKETT ST.",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "93257",
            "telephone_number": "559-737-4700",
            "fax_number": "559-734-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "HYDASH",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "559-737-4700"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.