Active NPI
County of Ventura
Doing business as Conejo Valley Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Thousand Oaks, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- H80CS00247-06-03
- Legal business name
- COUNTY OF VENTURA
- Doing business as
- Conejo Valley Family Medical Group FQHC
- Practice address
- 125 W Thousand Oaks Blvd
Suite 300
Thousand Oaks, CA 91360-4402 - Phone
- (805) 418-9100
- Fax
- (805) 370-0619
- NPI assigned
- Mar 23, 2009
- Last updated
- Jul 19, 2024
- Organization subpart
- Yes
- Parent organization
- VENTURA COUNTY MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa Cho, MD
- Title
- Director
- Phone
- (805) 677-5290
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | H80CS00247-06-03 | CA | Primary |
Addresses
Primary practice location
125 W Thousand Oaks Blvd
Suite 300
Thousand Oaks, CA 91360-4402
Mailing address
800 S Victoria Ave # L4615
Ventura, CA 93009-0003
Phone (805) 677-5210
Other names 1
- Conejo Valley Family Medical Group FQHC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000587 | CA | Part B Supplier - Clinic/Group Practice | 7911810171 |
Receives reassigned benefits from 748 practitioners 40 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ventura, CA; Fillmore, CA; Thousand Oaks, CA; Camarillo, CA; Oxnard, CA; Santa Paula, CA; Simi Valley, CA |
| O20090717000250 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 7911810171 | Practice locations: Thousand Oaks, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1316188253. Details of each certification follow.
Federally qualified health center certification: CCN 051179
- Legal name
- COUNTY OF VENTURA
- Doing business as
- CONEJO VALLEY FAMILY MEDICAL GROUP FQHC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 14, 2009
- Last certification
- Aug 14, 2009
- Ownership / control type
- Non-profit – corporation
- Organization structure
- Other
- Enrollment address
- 125 W Thousand Oaks Blvd
Ste 300
Thousand Oaks, CA 91360-4460
Other NPIs with the same Medicare PAC ID 20
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
7911810171
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
7911810171
-
dba Las Islas Mobile
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1154600336
7911810171
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
7911810171
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
7911810171
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
7911810171
-
dba Public Health Services
- Public Health or Welfare Agency
- Oxnard, CA
- NPI 1528275351
7911810171
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
7911810171
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
7911810171
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
7911810171
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
7911810171
Other NPIs on the same Medicare enrollment 38
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba VCBH-South Oxnard Youth & Family Mental Health
- Community/Behavioral Health Agency
- Oxnard, CA
- NPI 1003509852
O20031112000587
-
dba VCBH - Fillmore Substance Use Services
- Community/Behavioral Health Agency
- Fillmore, CA
- NPI 1013129782
O20031112000587
-
dba VCBH - Simi Valley Substance Use Services
- Community/Behavioral Health Agency
- Simi Valley, CA
- NPI 1013139658
O20031112000587
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
O20031112000587
-
dba VCBH - South Oxnard Adult Mental Health
- Community/Behavioral Health Agency
- Oxnard, CA
- NPI 1053714725
O20031112000587
-
dba VCBH- Critical Care & Navigation Services
- Community/Behavioral Health Agency
- Oxnard, CA
- NPI 1104048743
O20031112000587
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
O20031112000587
-
dba VCBH - North Oxnard Adult Mental Health MD Satellite
- Community/Behavioral Health Agency
- Camarillo, CA
- NPI 1184918716
O20031112000587
-
dba VCMC Adult CSU
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Ventura, CA
- NPI 1205394525
O20031112000587
-
dba VCBH - Ventura Adult Mental Health
- Community/Behavioral Health Agency
- Ventura, CA
- NPI 1235259029
O20031112000587
-
dba VCBH - Phoenix School
- Community/Behavioral Health Agency
- Camarillo, CA
- NPI 1316350127
O20031112000587
-
dba VCBH - Fillmore Youth & Family Mental Health
- Community/Behavioral Health Agency
- Fillmore, CA
- NPI 1356560718
O20031112000587
National Provider Directory
National Provider Directory- Part of
- County of Ventura Area Agency on Aging
Locations
2240 E Gonzales Rd
Ste 100
Oxnard, CA 93036
Phone (805) 981-5151
1227 E Los Angeles Ave
Simi Valley, CA 93065
Phone (805) 582-4000
125 W Thousand Oaks Blvd
Ste 300
Thousand Oaks, CA 91360
Phone (805) 418-9100
300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Barry Zimmerman | Corporate Director | Mar 11, 2021 | |
| W-2 Managing Employee | Mar 11, 2021 | ||
| County of Ventura | 5% Or Greater Direct Ownership Interest | Jun 29, 1994 | 100% |
Owners & managing parties with NPI records 20
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
5% Or Greater Direct Ownership Interest
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
5% Or Greater Direct Ownership Interest
-
- State or Local Public Health Clinic/Center
- Oxnard, CA
- NPI 1134658644
5% Or Greater Direct Ownership Interest
-
dba Las Islas Mobile
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1154600336
5% Or Greater Direct Ownership Interest
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
5% Or Greater Direct Ownership Interest
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
5% Or Greater Direct Ownership Interest
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
5% Or Greater Direct Ownership Interest
-
dba Public Health Services
- Public Health or Welfare Agency
- Oxnard, CA
- NPI 1528275351
5% Or Greater Direct Ownership Interest
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
5% Or Greater Direct Ownership Interest
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
5% Or Greater Direct Ownership Interest
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
5% Or Greater Direct Ownership Interest
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 17
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ventura County Medical Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 1966 Aug 18, 2010 |
| Magnolia Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Las Islas Family Medical Group North | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Fillmore Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| John K Flynn Community Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Las Posas Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Feb 19, 2014 Jan 1, 2013 |
| Sierra Vista Family Medical Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula Hospital Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Pediatric Diagnostic Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula West | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Mar 8, 2013 |
| Moorpark Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2008 |
| Mandalay Bay Womens & Childrens | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Santa Paula Medical Clinic | Federally qualified health center | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2013 |
| West Ventura Medical Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Las Islas Family Medical Group II | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Ventura County Healthcare for the Homeless Program | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 24, 2013 |
| Magnolia West | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2013 |
Owned or controlled facilities with NPI records 17
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
5% Or Greater Direct Ownership Interest
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Magnolia West
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1669738159
5% Or Greater Direct Ownership Interest
-
dba West Ventura Medical Clinic
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1780821660
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Santa Paula West FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1841431707
5% Or Greater Direct Ownership Interest
Facilities with the same owner 17
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
County of Ventura
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
County of Ventura
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
County of Ventura
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
County of Ventura
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
County of Ventura
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
County of Ventura
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
County of Ventura
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
County of Ventura
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
County of Ventura
-
dba Magnolia West
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1669738159
County of Ventura
-
dba West Ventura Medical Clinic
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1780821660
County of Ventura
-
dba Santa Paula West FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1841431707
County of Ventura
Practitioners & affiliated clinicians
Practitioners 348
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.
-
- Family Medicine Physician
- Ventura, CA
- NPI 1841353893
-
- Cardiovascular Disease Physician
- Moorpark, CA
- NPI 1376862938
-
- Pediatric Nurse Practitioner
- Ventura, CA
- NPI 1861974925
-
- Internal Medicine Physician
- Ventura, CA
- NPI 1942411657
-
- Physician Assistant
- Ventura, CA
- NPI 1871837872
-
- Family Medicine Physician
- Ventura, CA
- NPI 1770713190
-
- Family Medicine Physician
- Ventura, CA
- NPI 1114955994
-
- Pediatrics Physician
- Ventura, CA
- NPI 1366641961
-
- Nurse Practitioner
- Thousand Oaks, CA
- NPI 1619193208
-
- Internal Medicine Physician
- Santa Paula, CA
- NPI 1831293273
-
- Critical Care Medicine (Internal Medicine) Physician
- Ventura, CA
- NPI 1699849489
-
- Family Medicine Physician
- Ventura, CA
- NPI 1790834638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237766400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721347200000",
"number": "1316188253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S VICTORIA AVE # L4615",
"city": "VENTURA",
"state": "CA",
"postal_code": "930090003",
"telephone_number": "805-677-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W THOUSAND OAKS BLVD",
"address_2": "SUITE 300",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913604402",
"telephone_number": "805-418-9100",
"fax_number": "805-370-0619"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF VENTURA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VENTURA COUNTY MEDICAL CENTER",
"enumeration_date": "2009-03-23",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A",
"authorized_official_last_name": "CHO",
"authorized_official_first_name": "THERESA",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "805-677-5290",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CA",
"license": "H80CS00247-06-03",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Conejo Valley Family Medical Group FQHC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Conejo Valley Family Medical Group FQHC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Thousand Oaks, CA
- Amanda Lynn Cotner, FNP-C
- Patrick Cotter, MA, MPT, DPT
- Madeline Cotto, MD
- Couch Dental Corp.
- Country Oaks Inc (Country Oaks Pharmacy)
- County of Ventura (VCBH - Conejo Valley Adult Mental Health)
- County of Ventura (VCBH - Thousand Oaks Substance Use Services)
- County of Ventura (VCBH - Conejo Valley Youth & Family Mental Health)
- Eddie Laron Courtney
- Amanda Judith Cowden, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.