NPIMap

Organization Active NPI

Kaweah Delta Health Care District

Doing business as Kaweah Health Valencia Clinic

  • Rural Health Clinic/Center
  • Woodlake, CA
National Provider Identifier
1245071448
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KAWEAH DELTA HEALTH CARE DISTRICT
Doing business as
Kaweah Health Valencia Clinic
Practice address
132 S Valencia Blvd
Woodlake, CA 93286-1712
Phone
(559) 839-2300
Fax
(559) 564-1024
NPI assigned
Jun 3, 2024
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
KAWEAH DELTA HEALTH CARE DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Malinda Tupper
Title
Chief Financial Officer
Phone
(559) 624-4065

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Case Manager/Care Coordinator 171M00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

132 S Valencia Blvd
Woodlake, CA 93286-1712

Mailing address

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-5006

Other names 1

  • Kaweah Health Valencia Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251009002000 CA Part A Provider - Rural Health Clinic 6608778790 Practice locations: Woodlake, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245071448. Details of each certification follow.

Rural health clinic certification: CCN 058734

Legal name
KAWEAH DELTA HEALTH CARE DISTRICT
Doing business as
KAWEAH HEALTH VALENCIA CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 5, 2026
Last certification
Mar 5, 2026
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
132 S Valencia Blvd
Woodlake, CA 93286-1712
Related CCNs
050057

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 16

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

View all 16

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
05D2314326Kaweah Health Valencia Clinic132 S Valencia Blvd, Woodlake, CA 93286Certificate of waiverNov 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Kaweah Delta Non Inv Ca27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

132 S Valencia Blvd
Woodlake, CA 93286
Phone (559) 839-2300

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
Gary Herbst Individual Corporate OfficerChief Executive Officer Sep 1, 2017
W-2 Managing EmployeeChief Executive Officer Sep 1, 2017
Lynn Mirviss Individual Operational/Managerial ControlGoverning Body (Zone 2) Apr 29, 2010
Jagdev Batth Individual Corporate OfficerChief Operating Officer Mar 1, 2020
W-2 Managing EmployeeChief Operating Officer Mar 1, 2020
Dean Levitan Individual Operational/Managerial ControlGoverning Body (Zone 3) Feb 9, 2024
Anthony Olmos Individual Operational/Managerial ControlGoverning Body (Zone 1) Dec 4, 2020
Benjamin Cripps Individual Corporate OfficerChief Compliance & Risk Officer Feb 12, 2017
W-2 Managing EmployeeChief Compliance & Risk Officer Feb 12, 2017
Malinda Tupper Individual Corporate OfficerChief Financial Officer Feb 4, 2018
W-2 Managing EmployeeChief Financial Officer Feb 4, 2018
Armando Murrieta Individual Operational/Managerial ControlGoverning Body (Zone 5) Dec 4, 2024
Kaweah Delta Health Care District Organization, Visalia, CA 5% Or Greater Direct Ownership Interest Jun 19, 2025 100%
David Francis Individual Operational/Managerial ControlGoverning Body (Zone 4) Mar 22, 2018
Ryan Gates Individual Corporate OfficerChief Ambulatory Officer Feb 12, 2017
W-2 Managing EmployeeChief Ambulatory Officer Feb 12, 2017

Owners & managing parties with NPI records 17

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

View all 17

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kaweah Health Medical CenterVisalia, CA, CCN 050057 Hospital Operational/Managerial Control Jul 1, 1967
Kaweah Health Rehabilitation HospitalVisalia, CA, CCN 05T057 Hospital 5% Or Greater Direct Ownership Interest Nov 26, 2007
Kaweah Health Mental Health HospitalVisalia, CA, CCN 05S057 Hospital 5% Or Greater Direct Ownership Interest Nov 26, 2007
Kaweah Health Skilled Nursing CenterVisalia, CA, CCN 555396 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Oct 24, 1989
Dec 16, 2024
Jan 7, 2025
Kaweah Health Home HealthVisalia, CA, CCN 057255 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jul 17, 2008
Kaweah Health HospiceVisalia, CA, CCN 051748 Hospice 5% Or Greater Direct Ownership Interest (100%) May 16, 2002
Kaweah Health Exeter ClinicExeter, CA, CCN 058508 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 17, 2008
Kaweah Health Lindsay ClinicLindsay, CA, CCN 058649 Rural health clinic 5% Or Greater Direct Ownership Interest Jun 19, 2009
Kaweah Health Woodlake ClinicWoodlake, CA, CCN 058659 Rural health clinic Other Jan 12, 2012
Kaweah Health Dinuba ClinicDinuba, CA, CCN 058677 Rural health clinic Operational/Managerial Control Sep 1, 2014
Kaweah Health Tulare ClinicTulare, CA, CCN 058717 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2021

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1245071448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MINERAL KING AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916237",
            "telephone_number": "559-624-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S VALENCIA BLVD",
            "city": "WOODLAKE",
            "state": "CA",
            "postal_code": "932861712",
            "telephone_number": "559-839-2300",
            "fax_number": "559-564-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAWEAH DELTA HEALTH CARE DISTRICT",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "TUPPER",
        "authorized_official_first_name": "MALINDA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "559-624-4065"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaweah Health Valencia Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaweah Health Valencia Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodlake, CA

Sources for this page

Verify at the official NPI Registry.