NPIMap

Organization Active NPI

Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1225599178
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LOS ANGELES LGBT CENTER
Practice address
3055 Wilshire Blvd Ste 360
Los Angeles, CA 90010-1108
Phone
(323) 993-2900
NPI assigned
Mar 25, 2019
Last updated
Oct 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LOS ANGELES LGBT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Robyn Goldman
Title
Chief Financial Officer
Phone
(323) 993-8948

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3055 Wilshire Blvd Ste 360
Los Angeles, CA 90010-1108

Mailing address

1625 Schrader Blvd
Los Angeles, CA 90028-6213
Phone (323) 993-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210601001317 CA Part A Provider - Federally Qualified Health Center (FQHC) 8729975453 1 other NPI on this enrollment
Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225599178. Details of each certification follow.

Federally qualified health center certification: CCN 921961

Legal name
LOS ANGELES LGBT CENTER
Doing business as
TRANS WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 1, 2021
Last certification
Jun 1, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 4, 1972 in CA
Enrollment address
3055 Wilshire Blvd
Ste 360
Los Angeles, CA 90010-1108

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles LGBT Center7 organizations share this tax ID, including this one
Part of
Los Angeles LGBT Center

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2313 W Martin Luther King Jr Blvd
Los Angeles, CA 90008
Phone (323) 860-3799

553 S Clarence St
Ste 6
Los Angeles, CA 90033
Phone (323) 286-7224

8745 Santa Monica Blvd
West Hollywood, CA 90069
Phone (310) 550-1010

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Marki Knox Individual Corporate Director Jan 1, 2005
Amy Yanow Individual Corporate Director Sep 1, 2018
Alfred Fraijo Individual Corporate Director Feb 1, 2018
Teresa Ayers Individual Corporate Director Sep 1, 2015
Jordan Held Individual Corporate Director Jan 1, 2021
Jason Edward Patria Individual Corporate Director Jul 1, 2010
Tamika Butler Individual Corporate Director Jan 1, 2021
Annie Nisa Imhoff Individual Corporate Director Feb 1, 2019
Luann Boylan Individual Corporate Director Jan 1, 1993
Donald Ray Thomas Individual Corporate Director Feb 1, 2019
Robyn L Goldman Individual Corporate OfficerChief Financial Officer Mar 18, 2024
Sarah Christina Dusseault Individual Corporate Director Feb 1, 2019
Susan Feniger Individual Corporate Director Jan 1, 2007
Carlos Medina Individual Corporate Director Jan 1, 2015
Robert Bolan Individual W-2 Managing Employee Dec 1, 2009
Lucinda Davis Moorhead Individual Corporate Director Feb 1, 2019
Frank Pond Individual Corporate Director Nov 1, 2012

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 133

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 133

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1225599178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 WILSHIRE BLVD STE 360",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101108",
            "telephone_number": "323-993-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES LGBT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOS ANGELES LGBT CENTER",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "323-993-8948"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.