Watts Healthcare Corporation

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

9600013 Issued in CA

Legal business name

WATTS HEALTHCARE CORPORATION

Practice address

3756 Santa Rosalia Dr
Suite 400
Los Angeles, CA 90008-3606

Phone

(323) 357-6684

NPI assigned

Feb 5, 2007

Organization subpart

Yes

Parent organization

WATTS HEALTHCARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mr. William Hobson Jr.

Title

Chief Executive Officer

Phone

(323) 568-4417

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CRENSHAW COMMUNITY HEALTH CENTER Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 551972

Legal name

CRENSHAW COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 14, 2004

Last certification

Jun 14, 2004

Ownership / control type

For profit – partnership

Facility address

3756 Santa Rosalia Drive, Suite 400
Los Angeles, CA 90008

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

CLIA laboratory certificates

Part of

Watts Health Center

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1225177751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 COMPTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900023628",
            "telephone_number": "323-568-4417",
            "fax_number": "323-563-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR",
            "address_2": "SUITE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083606",
            "telephone_number": "323-357-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATTS HEALTHCARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WATTS HEALTHCARE CORPORATION",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "HOBSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-568-4417",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "9600013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70874G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRENSHAW COMMUNITY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Watt, LMFT
• Charles Watterson Jr.
• Watts Clinic Pharmacy
• Watts Health Care Corporation, Inc
• Watts Healthcare Corporation
• Watts Healthcare Corporation
• Watts Healthcare Corporation
• Watts Healthcare Corporation
• Watts World Revival
• Ashley Watts

• Federally Qualified Health Center (FQHC) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.