NPIMap

Organization Active NPI

Health and Life Organization, Inc

Doing business as Sacramento Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
National Provider Identifier
1144600248
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH AND LIFE ORGANIZATION, INC
Doing business as
Sacramento Community Clinic
Practice address
3030 Explorer Dr
Sacramento, CA 95827-2728
Phone
(916) 254-5700
NPI assigned
Jun 3, 2015
Last updated
Nov 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH AND LIFE ORGANIZATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Authorized official

Name
Jerry T. Bliatout, JD
Title
Administrator
Phone
(916) 642-1867

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3030 Explorer Dr
Sacramento, CA 95827-2728

Mailing address

3030 Explorer Dr
Sacramento, CA 95827-2728
Phone (916) 642-1867

Other names 1

  • Sacramento Community Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151209002387 CA Part A Provider - Federally Qualified Health Center (FQHC) 1153361886 Practice locations: Sacramento, CA
O20230607003131 CA Part A Provider - Federally Qualified Health Center (FQHC) 1153361886 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1144600248. Details of each certification follow.

Federally qualified health center certification: CCN 751819

Legal name
HEALTH AND LIFE ORGANIZATION, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 24, 2015
Last certification
Nov 24, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3030 Explorer Dr
Sacramento, CA 95827-2728

Federally qualified health center certification: CCN A01153

Legal name
HEALTH AND LIFE ORGANIZATION, INC
Doing business as
SACRAMENTO COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 4, 2023
Last certification
May 4, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
5524 Assembly CT
Sacramento, CA 95823-2625

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Health and Life Organization Inc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Bruce Her Individual Corporate DirectorBoard of Director Oct 1, 2015
Steven Vang Individual Corporate DirectorDirector Apr 1, 2023
Corporate DirectorBoard of Director Mar 10, 2023
Steven Narine Individual Corporate DirectorDirector Mar 21, 2022
Corporate DirectorBoard of Director Mar 21, 2022
Albert Moua Individual Corporate OfficerCoo Dec 1, 2016
Corporate Officer Dec 1, 2016
Jerry Bliatout Individual Corporate OfficerCeo Aug 2, 2004 100%
Operational/Managerial ControlCeo Aug 2, 2004 100%
Anita Charles Individual Corporate DirectorBoard of Director Apr 1, 2015
Sabrina Barnes Individual Corporate DirectorBoard of Director Dec 1, 2009
Sylvia Sanderford Individual Corporate DirectorDirector Aug 1, 2023
Corporate Director Aug 1, 2023
Meneu Yang Individual Corporate DirectorDirector Dec 18, 2023
Corporate Director Dec 18, 2023
Chua Her Individual Corporate DirectorBoard of Director Apr 1, 2014
Mai Vang Individual Corporate DirectorDirector Oct 14, 2022
Corporate DirectorBoard of Director Oct 14, 2022
Thang Yang Individual Corporate DirectorDirector May 1, 2022
Corporate Director May 1, 2022
Bobby Bliatout Individual Corporate OfficerCfo Dec 1, 2003
Corporate Officer Dec 1, 2003
Stephen Lakos Individual Corporate DirectorBoard of Director Sep 1, 2007

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Sacramento Community Clinic - B. Teri Burns ClinicSacramento, CA, CCN 051958 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 19, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1144600248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 EXPLORER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272728",
            "telephone_number": "916-642-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 EXPLORER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272728",
            "telephone_number": "916-254-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND LIFE ORGANIZATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH AND LIFE ORGANIZATION, INC.",
        "enumeration_date": "2015-06-03",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "BLIATOUT",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-642-1867",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "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": [
        {
            "organization_name": "Sacramento Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sacramento Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.