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Bay Area Community Health

Organization Active NPI Federally Qualified Health Center (FQHC) · Fremont, CA

NPI 1184791998 · NPPES record last updated Feb 23, 2024

Key facts

NPI
1184791998
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
550000139 (CA)
Legal business name
BAY AREA COMMUNITY HEALTH
Practice address
1999 Mowry Avenue Suite a&B&D&F&N
Fremont, CA 94538-1436
Phone
(510) 770-8040
Fax
(510) 623-8926
NPI assigned
Nov 29, 2006
Organization subpart
Yes
Parent organization (as reported)
BAY AREA COMMUNITY HEALTH

Authorized official

Name
Navneet Bains
Title
Deputy Director of Client Services
Phone
(916) 419-7292

Owned or controlled facilities with NPI records 4

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 10

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

Practitioners 146

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 146

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in CA

Federally qualified health center certification: CCN 551059

Legal name
BAY AREA COMMUNITY HEALTH
Doing business as
BAY AREA COMMUNITY HEALTH - MOWRY II
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 5, 2010
Last certification
Oct 5, 2010
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Dec 6, 1972 in CA
Enrollment address
1999 Mowry Ave
Suite a,D,F,N
Fremont, CA 94538-1723

Federally qualified health center certification: CCN 921196

Legal name
BAY AREA COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 25, 2019
Last certification
Oct 25, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Dec 6, 1972 in CA
Enrollment address
1860 Mowry Ave
Ste 400
Fremont, CA 94538-1730

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kobin Lee
Individual 		Corporate Director
Vice Chair /Board Member		 Nov 15, 2018
Corporate Director
Vice Chair / Board Member		 Nov 15, 2018
Jacqueline B Belser
Individual 		Corporate Director
Board Member Secretary		 Nov 15, 2018
Corporate Director
Board Member/Secretary		 Nov 15, 2018
Zettie D Page
Individual 		Corporate Officer
Ceo		 Jan 7, 2013 90%
Corporate Officer
Chief Executive Officer		 Nov 15, 2018
W-2 Managing Employee
Authorized Official		 Nov 15, 2018
Sherland D Headley
Individual 		Corporate Director
Board Member		 Nov 15, 2018
Xianzhong Zhu
Individual 		Corporate Director
Treasurer / Board Member		 Nov 15, 2018
Corporate Director
Secretary Board Member		 Nov 15, 2018
Brenda L Quillin
Individual 		Corporate Officer
Board Member		 Feb 1, 2013
Corporate Director
Board Member		 Nov 15, 2018
Stephanie J Reddell
Individual 		Corporate Officer
Board Member		 Feb 1, 2013
Corporate Director
Board Member		 Nov 15, 2018
Ana Robledo
Individual 		Corporate Officer Aug 8, 2024
W-2 Managing Employee
Authorized Official		 Aug 8, 2024
Corporate Director Aug 4, 2024
Robert J Wyckoff
Individual 		Corporate Officer
Board Member		 Feb 1, 2013
Corporate Director
Chair Board Member		 Nov 15, 2018
Marvin L Wong
Individual 		Corporate Director
Board Member		 Nov 15, 2018

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Gilroy Health Clinic
Gilroy, CA · CCN 751868		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Bach Family Clinic
San Jose, CA · CCN 751182		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 1, 2020
Nov 15, 2018
Monterey Plaza Health Clinic
San Jose, CA · CCN 751869		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Mt. Pleasant School Based Clinic
San Jose, CA · CCN 751867		 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050330001237 CA Part B Supplier - Clinic/Group Practice 1658349824 Receives reassigned benefits from 150 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gilroy, CA; San Jose, CA; Fremont, CA
O20101005001046 CA Part a Provider - Federally Qualified Health Center (FQHC) 1658349824 Practice locations: Fremont, CA
O20191112002349 CA Part a Provider - Federally Qualified Health Center (FQHC) 1658349824 Practice locations: Fremont, CA

National Provider Directory

Part of
Tri City Family Plannin

Locations

40930 Fremont Blvd
Fremont, CA 94538

1860 Mowry Ave
Fremont, CA 94538
Phone (510) 608-6065

38056 Martha Ave
Fremont, CA 94536
Phone (510) 313-3917

1999 Mowry Ave
Ste Abdfn
Fremont, CA 94538
Phone (540) 770-8040

4949 Thornton Ave
Fremont, CA 94536

2380 Montpelier Dr
Ste 200
San Jose, CA 95116
Phone (408) 254-1800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator
Group: 193400000X SINGLE SPECIALTY GROUP		 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X 550000139 CA Yes

Addresses

Primary practice location

1999 Mowry Avenue Suite a&B&D&F&N
Fremont, CA 94538-1436

Mailing address

40910 Fremont Blvd
Fremont, CA 94538-4375
Phone (510) 770-8040

Other practice location 1

5504 Monterey Hwy
San Jose, CA 95138-1529
Phone (408) 729-9700

Other practice location 2

2380 Montpelier Dr Ste 400
San Jose, CA 95116-1620
Phone (408) 729-9700

Other practice location 3

2380 Montpelier Dr Ste 200
San Jose, CA 95116-1620
Phone (408) 729-9700

Other practice location 4

1650 S White Rd
San Jose, CA 95127-4758
Phone (408) 928-5250

Other practice location 5

1066 S White Rd Ste 170
San Jose, CA 95127-3812
Phone (408) 729-9700

Other practice location 6

9460 No Name Uno,
Suite 110
Gilroy, CA 95020
Phone (408) 729-9700

Other practice location 7

2060 Aborn Rd Ste 125
San Jose, CA 95121-1586
Phone (408) 729-9700

Other practice location 8

1860 Mowry Ave Ste 400
Fremont, CA 94538-1730
Phone (510) 770-8040

Other practice location 9

4949 Thornton Ave
Fremont, CA 94536-6412
Phone (510) 770-8040

Other practice location 10

38056 Martha Ave
Fremont, CA 94536-3809
Phone (510) 770-8040

Other practice location 11

242 La Pala Dr Ste A&b
San Jose, CA 95127-2103
Phone (408) 729-9700

Other practice location 12

9460 No Name Uno
Suite 215
Gilroy, CA 95020
Phone (408) 729-9700

Other identifiers

IdentifierTypeStateIssuer
FHC71115FMedicaidCA
550000139OtherCACOMMUNITY CLINIC LICENSE

Other names

  • Aborn Dental Clinic Doing business as
  • BACH - Mobile Health Clinic #6 Doing business as
  • BACH - Mobile Health Clinic #7 Doing business as
  • BACH Dental Mobile Clinic V Doing business as
  • BACH Family Clinic Doing business as
  • BACH Mobile Health Clinic IV Doing business as
  • BACH Senior Mobile Health Clinic I Doing business as
  • Bach- Mobile Health Clinic #8 Doing business as
  • Bay Area Community Health - Mowry II Doing business as
  • Bay Area Community Health - Mowry III Clinic Doing business as
  • Bay Area Community Health Center Of Gilroy Doing business as
  • Bay Area Community Health Center Of Gilroy - Dental Doing business as
  • La Pala Dental Clinic Doing business as
  • Martha Ave Dental Doing business as
  • Monterey Plaza Health Clinic Doing business as
  • Montpelier Health Center Doing business as
  • Montpelier Health Center - Dental Doing business as
  • Mt. Pleasant Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2024.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1184791998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8040",
            "fax_number": "510-623-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 MOWRY AVENUE SUITE A&B&D&F&N",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381436",
            "telephone_number": "510-770-8040",
            "fax_number": "510-623-8926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5504 Monterey Hwy",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951381529",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2380 Montpelier Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951161620",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2380 Montpelier Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951161620",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 S White Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951274758",
            "country_code": "US",
            "telephone_number": "408-928-5250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1066 S White Rd Ste 170",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951273812",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9460 No Name Uno,",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "95020",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2060 Aborn Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951211586",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1860 Mowry Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945381730",
            "country_code": "US",
            "telephone_number": "510-770-8040",
            "fax_number": "510-625-8926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4949 Thornton Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945366412",
            "country_code": "US",
            "telephone_number": "510-770-8040",
            "fax_number": "510-625-8926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38056 Martha Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945363809",
            "country_code": "US",
            "telephone_number": "510-770-8040",
            "fax_number": "510-625-8926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "242 La Pala Dr Ste A&b",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951272103",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9460 No Name Uno",
            "address_2": "Suite 215",
            "address_purpose": "LOCATION",
            "city": "Gilroy",
            "state": "CA",
            "postal_code": "95020",
            "country_code": "US",
            "telephone_number": "408-729-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAY AREA COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAY AREA COMMUNITY HEALTH",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "BAINS",
        "authorized_official_first_name": "NAVNEET",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR OF CLIENT SERVICES",
        "authorized_official_telephone_number": "916-419-7292"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE 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": "CA",
            "license": "550000139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC71115F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CLINIC LICENSE",
            "identifier": "550000139",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aborn Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH - Mobile Health Clinic #6",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH - Mobile Health Clinic #7",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH Dental Mobile Clinic V",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH Mobile Health Clinic IV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH Mobile Health Clinic IV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BACH Senior Mobile Health Clinic I",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bach- Mobile Health Clinic #8",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Community Health - Mowry II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Community Health - Mowry III Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Community Health Center Of Gilroy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bay Area Community Health Center Of Gilroy - Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "La Pala Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martha Ave Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monterey Plaza Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montpelier Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montpelier Health Center - Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mt. Pleasant Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

All providers in Fremont, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.