Omni Family Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Fresno, CA
NPI 1205367646 · NPPES record last updated Jul 8, 2025
Key facts
- NPI
- 1205367646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- OMNI FAMILY HEALTH
- Practice address
- 4844 N 1St St Ste 104
Fresno, CA 93726-0529 - Phone
- (866) 707-6664
- Fax
- (661) 746-9197
- NPI assigned
- Mar 27, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Francisco L Castillon
- Title
- Chief Executive Officer
- Phone
- (661) 630-7045
Other NPIs on the same Medicare enrollment 41
Practitioners 2
-
Chang Sook Kim, FNP
-
Christine M. McLemore, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 921125
- Legal name
- OMNI FAMILY HEALTH
- Certification status
- Terminated Voluntary: merger or closure, Jun 2, 2025
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 23, 2019
- Last certification
- Jan 23, 2019
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 9, 1978 in CA
- Enrollment address
- 4844 N 1St St
Ste 104
Fresno, CA 93726-0529
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Susan Watkins |
Corporate Director |
Nov 5, 2013 | |
| David Brust |
Corporate Director |
Jun 8, 2016 | |
| Cynthia D Stewart |
W-2 Managing Employee |
Aug 5, 2018 | |
| Francisco L Castillon |
Corporate Officer |
Oct 1, 2010 | |
| W-2 Managing Employee |
Oct 1, 2010 | ||
| Manuel Flores |
Corporate Director |
Aug 4, 2015 | |
| Ruben Garcia |
Corporate Director |
Oct 1, 2019 | |
| Richard Sepulveda |
Corporate Director |
Feb 6, 2018 | |
| Kassandra Biviano |
Corporate Director |
Dec 7, 2021 | |
| Irma Montemayor |
Corporate Director |
Jan 12, 2021 | |
| John Sanchez |
Corporate Director |
Dec 7, 2021 | |
| Yolanda a Serna |
Corporate Director |
Jun 10, 2014 | |
| William Nyitray |
Corporate Director |
Nov 7, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
| O20181205003446 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 9234176363 | Practice locations: Fresno, CA |
National Provider Directory
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | CA | Yes |
Addresses
Primary practice location
4844 N 1St St Ste 104
Fresno, CA 93726-0529
Mailing address
4900 California Ave
400B
Bakersfield, CA 93309-7081
Phone (661) 459-1900
Other providers in Fresno, CA
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- Omni Anesthesia Associates, Inc.
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All providers in Fresno, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.