Organization Active NPI

North Orange County Regional Health Foundation

  • Community Health Clinic/Center
  • Anaheim, CA
National Provider Identifier
1194974402
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
550000830 Issued in CA
Legal business name
NORTH ORANGE COUNTY REGIONAL HEALTH FOUNDATION
Practice address
1182 N Euclid St
Anaheim, CA 92801-1900
Phone
(714) 441-0411
Fax
(714) 441-1824
NPI assigned
Sep 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Authorized official

Name
Rocio Magdaleno
Title
Chief Executive Officer
Phone
(657) 276-7603

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1194974402 CA
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 1194974402 CA
Community/Behavioral Health Agency 251S00000X
Community Health Clinic/Center 261QC1500X 550000830 CA Primary

Addresses

Primary practice location

1182 N Euclid St
Anaheim, CA 92801-1900

Mailing address

1182 N Euclid St
Anaheim, CA 92801-1900
Phone (714) 441-0411

Other identifiers 1

IdentifierTypeStateIssuer
1194974402MedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100820001006 CA Part B Supplier - Clinic/Group Practice 4082748397 Receives reassigned benefits from 4 practitioners
Practice locations: Anaheim, CA
O20140217001064 CA Part A Provider - Federally Qualified Health Center (FQHC) 4082748397 Practice locations: Anaheim, CA

Federally qualified health center certification: CCN 751094

Legal name
NORTH ORANGE COUNTY REGIONAL HEALTH FOUNDATION
Doing business as
FAMILY HEALTH MATTERS COMMUNITY HEALTH CENTER
Organization structure
CorporationNon-profit
Incorporated
in CA
Enrollment address
1182 N Euclid St
Anaheim, CA 92801-1900

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2212453North Orange County Regional Health Foundation1182 N Euclid St, Anaheim, CA 92801Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory

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
Renee Kaminski Individual Corporate DirectorBoard Member May 1, 2013
Herberto Hernandez Individual Corporate DirectorBoard Member May 1, 2013
Debbie Cardenas Individual Corporate OfficerCeo Sep 1, 2013 100%
W-2 Managing EmployeeCeo May 1, 2013 100%
Erika Medina Individual Corporate DirectorBoard Member May 1, 2013
Bridgette Waller Individual Corporate DirectorBoard Member May 1, 2013
Catherin Curm Individual Corporate DirectorBoard Member May 1, 2013
Franklin Gonzalez Individual Corporate DirectorBoard Member May 1, 2013
Linda Low Individual Corporate DirectorBoard Member Aug 20, 2013
Sideharth Dakoria Individual Corporate DirectorBoard Member Jun 11, 2013
Mervat Morcos Individual Corporate DirectorChairman of the Board May 1, 2013
Ramona M Shelton-Finch Individual Corporate OfficerCeo Oct 15, 2018
W-2 Managing EmployeeCeo Oct 15, 2018

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1194974402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-441-0411",
            "fax_number": "714-441-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 N EUCLID ST",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-441-0411",
            "fax_number": "714-441-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ORANGE COUNTY REGIONAL HEALTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "MAGDALENO",
        "authorized_official_first_name": "ROCIO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "657-276-7603"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "1194974402",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "1194974402",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "550000830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194974402",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.