NPIMap

Organization Active NPI

Kedren Community Care Clinic - B

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1295257913
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KEDREN COMMUNITY CARE CLINIC - B
Practice address
4211 Avalon Blvd Ste B
Los Angeles, CA 90011-5622
Phone
(323) 232-2384
Fax
(323) 232-2384
NPI assigned
Jul 14, 2017
Last updated
Apr 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KEDREN COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Authorized official

Name
Leticia Perez
Title
Clinic Manager
Phone
(323) 232-2384

Specialties & licenses 1

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

Addresses

Primary practice location

4211 Avalon Blvd Ste B
Los Angeles, CA 90011-5622

Mailing address

4211 Avalon Blvd
HR Department
Los Angeles, CA 90011-5622
Phone (323) 582-2251

Other names 1

  • Kedren Community Care Clinic-B Other name

National Provider Directory

National Provider Directory
Tax ID family
Kedren Community Mental Health Center8 organizations share this tax ID, including this one
Part of
Kedren Community Mental Health Center

Other organizations with this tax ID 7

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

Locations

4211 Avalon Blvd
Bldg B
Los Angeles, CA 90011

4211 Avalon Blvd
Ste B
Los Angeles, CA 90011
Phone (323) 232-2384

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775779200000",
    "number": "1295257913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD",
            "address_2": "HR DEPARTMENT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-582-2251",
            "fax_number": "323-582-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 AVALON BLVD STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115622",
            "telephone_number": "323-232-2384",
            "fax_number": "323-232-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEDREN COMMUNITY CARE CLINIC - B",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEDREN COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2017-07-14",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LETICIA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "323-232-2384"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kedren Community Care Clinic-B",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kedren Community Care Clinic-B",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.