NPIMap

Organization Active NPI

Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
National Provider Identifier
1164934725
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OMNI FAMILY HEALTH
Practice address
4646 N 1St St
Fresno, CA 93726-0903
Phone
(866) 707-6664
Fax
(661) 746-9197
NPI assigned
Nov 3, 2017
Last updated
Jul 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Mr. Francisco L Castillon
Title
Chief Executive Officer
Phone
(661) 630-7045

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
General Practice Dentistry 1223G0001X NU

Addresses

Primary practice location

4646 N 1St St
Fresno, CA 93726-0903

Mailing address

4900 California Ave
400B
Bakersfield, CA 93309-7081
Phone (661) 459-1900

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050411000986 CA Part B Supplier - Clinic/Group Practice 9234176363 Receives reassigned benefits from 185 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fresno, CA; Hanford, CA; Lindsay, CA; Lost Hills, CA; Reedley, CA; Ridgecrest, CA; Shafter, CA; Taft, CA…
O20190807001303 CA Part A Provider - Federally Qualified Health Center (FQHC) 9234176363 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164934725. Details of each certification follow.

Federally qualified health center certification: CCN 921174

Legal name
OMNI FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 9, 2019
Last certification
Sep 9, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 2018 in CA
Enrollment address
4646 N 1St St
Fresno, CA 93726-0973

Other NPIs on the same Medicare enrollment 41

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

View all 41

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
Susan Watkins Individual Corporate OfficerBoard Member Nov 5, 2013
Corporate DirectorBoard Member Nov 5, 2013
David Brust Individual Corporate OfficerBoard Member Aug 8, 2016
Corporate DirectorBoard Member Aug 8, 2016
Cynthia D Stewart Individual W-2 Managing EmployeeDirector of Managed Care Aug 5, 2018
Francisco L Castillon Individual Corporate OfficerChief Executive Officer Oct 1, 2010
W-2 Managing EmployeeChief Executive Officer Oct 1, 2010
Manuel Flores Individual Corporate OfficerBoard Member Aug 4, 2015
Corporate DirectorBoard Member Aug 4, 2015
Ruben Garcia Individual Corporate OfficerBoard Member Oct 1, 2019
Corporate DirectorBoard Member Oct 1, 2019
Richard Sepulveda Individual Corporate OfficerBoard Member Feb 6, 2018
Corporate DirectorBoard Member Feb 6, 2018
Kassandra Biviano Individual Corporate OfficerBoard Member Dec 7, 2021
Corporate DirectorBoard Member Dec 7, 2021
Irma Montemayor Individual Corporate OfficerBoard Member Jan 12, 2021
Corporate DirectorBoard Member Jan 12, 2021
John Sanchez Individual Corporate OfficerBoard Member Dec 7, 2021
Corporate DirectorBoard Member Dec 7, 2021
Yolanda a Serna Individual Corporate OfficerBoard Member Jun 10, 2014
Corporate DirectorBoard Member Jun 10, 2014
William Nyitray Individual Corporate OfficerBoard Member Nov 7, 2017
Corporate DirectorBoard Member Nov 7, 2017

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1164934725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE",
            "address_2": "400B",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097081",
            "telephone_number": "661-459-1900",
            "fax_number": "661-746-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260903",
            "telephone_number": "866-707-6664",
            "fax_number": "661-746-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "CASTILLON",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "661-630-7045",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.