NPIMap

Organization Active NPI

Families Together of Orange County

  • Clinic/Center
  • Tustin, CA
National Provider Identifier
1194122457
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAMILIES TOGETHER OF ORANGE COUNTY
Practice address
661 W 1St St
Ste. G
Tustin, CA 92780-2939
Phone
(714) 665-9890
Fax
(714) 665-9891
NPI assigned
Dec 1, 2014
Last updated
Feb 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Alexander R Rossel
Title
Ceo
Phone
(714) 665-9890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

661 W 1St St
Ste. G
Tustin, CA 92780-2939

Mailing address

661 W 1St St
Ste. G
Tustin, CA 92780-2939
Phone (714) 665-9890

Other identifiers 2

IdentifierTypeStateIssuer
550003128OtherCALICENSE NUMBER
2563012OtherCANON PROFIT COORPORATION HEALTH CENTER

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151210000638 CA Part B Supplier - Clinic/Group Practice 7517268816 Receives reassigned benefits from 98 practitioners
Practice locations: Anaheim, CA; Fountain Valley, CA; Tustin, CA
O20180122000133 CA Part A Provider - Federally Qualified Health Center (FQHC) 7517268816 Practice locations: Tustin, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194122457. Details of each certification follow.

Federally qualified health center certification: CCN 921045

Legal name
FAMILIES TOGETHER OF ORANGE COUNTY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 26, 2017
Last certification
Dec 26, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 14, 2003 in CA
Enrollment address
661 W 1St St, Ste G
Tustin, CA 92780-2939

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

710 N Euclid St
#301
Anaheim, CA 92801

9918 Katella Ave
Anaheim, CA 92804
Phone (714) 644-9494

9918 Katella Ave
Ste A
Anaheim, CA 92804
Phone (949) 439-0006

9918 Katella Ave
Ste Ac
Anaheim, CA 92804
Phone (714) 644-9494

11180 Warner Ave
Ste 353
Fountain Vly, CA 92708
Phone (714) 751-3540

8771 Van Nuys Blvd
Panorama City, CA 91402

621 W 1st St
Tustin, CA 92780
Phone (714) 665-9890

661 W 1st St
Ste A
Tustin, CA 92780
Phone (714) 665-1175

36290 Hidden Springs Rd
Ste De
Wildomar, CA 92595
Phone (951) 483-2020

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Nathaniel Baek Individual Corporate DirectorBoard Member Aug 1, 2018
Alexander R Rossel Individual Corporate OfficerChief Executive Officer Jan 1, 2015 50%
W-2 Managing EmployeeChief Executive Officer Jan 1, 2015 50%
Operational/Managerial ControlChief Executive Officer Jan 1, 2015 50%
Stephen Murphy Individual Corporate OfficerChief Financial Officer Jan 1, 2015 50%
W-2 Managing EmployeeChief Financial Officer Jan 1, 2015 50%
Operational/Managerial ControlChief Financial Officer Jan 1, 2015 50%
Priscilla Baek Individual Corporate DirectorBoard Member Feb 1, 2023
Xiao Min Xiong Individual Corporate DirectorBoard Member Jan 1, 2022
Abigail Kwon Individual Corporate DirectorBoard Member Jan 1, 2024
Nayeli Moreno-Sanchez Individual Corporate DirectorBoard Member Dec 1, 2016
Karen Lee Individual Corporate DirectorChairman of the Board Dec 1, 2016
Araceli Cazales Individual Corporate DirectorBoard Member Dec 1, 2016
Alice Maldonado Individual Corporate DirectorBoard Member Dec 1, 2017
Joshua Kwon Individual Corporate DirectorBoard Member May 1, 2020
Marcos Roman Individual Corporate DirectorBoard Member Jan 1, 2022
Monica Guardado Individual Corporate DirectorSecretary of the Board Jan 1, 2023

Practitioners & affiliated clinicians

Practitioners 119

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 119

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1194122457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST",
            "address_2": "STE. G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST",
            "address_2": "STE. G",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-9890",
            "fax_number": "714-665-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIES TOGETHER OF ORANGE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "ROSSEL",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-665-9890"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "550003128",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON PROFIT COORPORATION HEALTH CENTER",
            "identifier": "2563012",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.