NPIMap

Organization Active NPI

H Street Clinic

  • Community Health Clinic/Center
  • Norwalk, CA
National Provider Identifier
1073259305
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
H STREET CLINIC
Practice address
13122 Studebaker Rd
Norwalk, CA 90650-2531
Phone
(562) 888-5944
Fax
(562) 888-5945
NPI assigned
May 10, 2022
Organization subpart
Yes
Parent organization
H STREET CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Eleanor Perez
Title
Cao
Phone
(626) 488-3111

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X
Case Management Agency 251B00000X
Supports Brokerage Agency 251X00000X
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

13122 Studebaker Rd
Norwalk, CA 90650-2531

Mailing address

2700 S Grand Ave
Los Angeles, CA 90007-3301
Phone (213) 536-5815

Other names 1

  • Central Neighborhood Health Foundation - Norwalk Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240425000565 CA Part A Provider - Federally Qualified Health Center (FQHC) 3870693781 Practice locations: Norwalk, CA

Federally qualified health center certification: CCN A01878

Legal name
H STREET CLINIC
Doing business as
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION - NORWALK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 19, 2024
Last certification
Apr 19, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 18, 2006 in CA
Enrollment address
13132 Studebaker Rd
Ste a
Norwalk, CA 90650-2573

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
H Street Clinic14 organizations share this tax ID, including this one
Part of
H Street Clinic

Other organizations with this tax ID 13

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

View all 13

Locations

13100 Studebaker Rd
Ste A
Norwalk, CA 90650

13122 Studebaker Rd
Norwalk, CA 90650
Phone (562) 888-5944

Ownership & related parties

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.

NameRoleSinceShare
Crystal Lautrup Individual Corporate DirectorBoard Member Mar 31, 2018
Chukwuka a Chidi Individual Corporate OfficerCfo Apr 1, 2020
James Mackey Individual Corporate DirectorBoard Chairman Feb 18, 2009
Victor Garcia Individual Corporate DirectorBoard Member Sep 14, 2018
Kenneth M. Orduna Individual Corporate OfficerCeo Jul 1, 2018
Operational/Managerial ControlCeo Jul 1, 2018
Wanda L Thompson Individual Corporate Director Mar 28, 2019
Richard Mayer Individual Corporate DirectorBoard Treasurer Feb 18, 2009
Nancy Ochoa Individual Corporate DirectorBoard Member Sep 23, 2020
Mary McDonald Winners Individual Corporate DirectorBoard Vice-Chair Nov 18, 2010
Oscar Lopez Individual Corporate DirectorBoard Member Aug 1, 2019
Frank J Ybarra Individual Corporate DirectorBoard Member Jul 26, 2019

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1073259305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S GRAND AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073301",
            "telephone_number": "213-536-5815",
            "fax_number": "213-478-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13122 STUDEBAKER RD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502531",
            "telephone_number": "562-888-5944",
            "fax_number": "562-888-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H STREET CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "H STREET CLINIC",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-06-03",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "626-488-3111"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Neighborhood Health Foundation - Norwalk",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Neighborhood Health Foundation - Norwalk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.