NPIMap

Organization Active NPI

JWCH Institute Inc

Doing business as Wesley Health Centers - Health and Wellness Center 2

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
National Provider Identifier
1073209177
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
JWCH INSTITUTE INC
Doing business as
Wesley Health Centers - Health and Wellness Center 2
Practice address
45124 10TH St W
Lancaster, CA 93534-2310
Phone
(866) 733-5924
NPI assigned
Apr 12, 2023
Last updated
Apr 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Alvaro Prospero Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 1

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

Addresses

Primary practice location

45124 10TH St W
Lancaster, CA 93534-2310

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other names 1

  • Wesley Health Centers - Health and Wellness Center 2 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230711002570 CA Part A Provider - Federally Qualified Health Center (FQHC) 1850394123 Practice locations: Lancaster, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073209177. Details of each certification follow.

Federally qualified health center certification: CCN A01174

Legal name
JWCH INSTITUTE INC
Doing business as
WESLEY HEALTH CENTERS - HEALTH AND WELLNESS CENTER 2
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 11, 2023
Last certification
Jul 11, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 4, 1960 in CA
Enrollment address
45124 10TH St W
Lancaster, CA 93534-2310

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2285277Wesley Health Centers-Health and Wellness Center 245124 10TH St West, Lancaster, CA 93534Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wesley Health Centers - Midnight Mission69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

5600 Rickenbacker Rd
Bldg 1E
Bell, CA 90201
Phone (323) 263-8840

15898 Gale Ave
Hacienda Heights, CA 91745
Phone (626) 346-3750

45124 10th St W
Lancaster, CA 93534
Phone 6619419543 ext. 6300

1774 Zonal Ave
Bldg E
Los Angeles, CA 90033
Phone (323) 352-5650

442 S San Pedro St
Los Angeles, CA 90013
Phone (213) 223-2900

500 S San Pedro St
Los Angeles, CA 90013
Phone (213) 285-4260

721 E 5th St
Los Angeles, CA 90013
Phone (213) 622-4073

855 N Vermont Ave
Ste 120
Los Angeles, CA 90029
Phone 32395340002485

3590 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 223-1035

37926 47th St E
Palmdale, CA 93552
Phone 32320145163204

10750 Laurel Ave
Whittier, CA 90605
Phone (562) 295-6595

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Thomas Grode Individual Corporate DirectorBoard Member Jan 26, 2016
Joseph Castel Individual Corporate DirectorBoard Member - Secretary Jul 13, 2004
Andy Irie Individual Corporate OfficerChief Administrative Officer Jan 1, 2010
Paul Gerald Gregerson Individual Corporate OfficerChief Medical Officer Jan 1, 2001
Christopher Ewing Individual Corporate DirectorBoard Member Jun 28, 2022
Ana Ortiz Individual Corporate OfficerChief Dental Officer Nov 14, 2016
Jeanne Lam Individual Corporate OfficerChief Financial Officer Jul 1, 2005
Eduardo Saucedo Individual Corporate DirectorBoard Member Jul 26, 2016
Tien Dang Individual Corporate OfficerChief Information Officer Apr 30, 2014
Alvaro P Ballesteros Individual Corporate OfficerChief Executive Officer Oct 1, 2003
Annette Sullivan Individual Corporate DirectorBoard Member Feb 23, 2021
Herbert Torrence Individual Corporate DirectorBoard Member Feb 28, 2017
Kathleen House Individual Corporate DirectorBoard Member - Vice Chair Nov 22, 2011
Silvia Hernandez Individual Corporate DirectorBoard Member Sep 23, 2014
Cynthia Lopez Individual Operational/Managerial ControlClinic Administrator Aug 31, 2023
Lawrence Fernandez Individual Corporate DirectorBoard Member Jun 25, 2002
Brenda Velasquez Individual Corporate OfficerChief Operating Officer Jul 19, 2022
Maria a Padron Individual Corporate DirectorBoard Member Feb 14, 2007
Sheila Eaton Individual Corporate DirectorBoard Member Sep 24, 2013
Marie S. Torres Individual Corporate DirectorBoard Member Apr 26, 2022

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
JWCH Medical Clinic @ Bell ShelterBell, CA, CCN 751883 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2015
Wesley Health Centers - Palmdale CentralPalmdale, CA, CCN 921169 Federally qualified health center Operational/Managerial Control (100%) Apr 15, 2019

Practitioners & affiliated clinicians

Practitioners 168

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 168

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1073209177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45124 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "866-733-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "PROSPERO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Health Centers - Health and Wellness Center 2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.