NPIMap

Organization Active NPI

Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Livermore, CA
National Provider Identifier
1336990506
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AXIS COMMUNITY HEALTH INC
Practice address
1686 Second St
Livermore, CA 94550-4328
Phone
(925) 462-1755
NPI assigned
Mar 27, 2024
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AXIS COMMUNITY HEALTH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Elizabeth Perez-Howe
Title
Ceo
Phone
(925) 462-1755

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1686 Second St
Livermore, CA 94550-4328

Mailing address

5925 W Las Positas Blvd Ste 100
Pleasanton, CA 94588-8537

Other names 1

  • AXIS COMMUNITY HEALTH Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251210001039 CA Part A Provider - Federally Qualified Health Center (FQHC) 7012975071 Practice locations: Livermore, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336990506. Details of each certification follow.

Federally qualified health center certification: CCN A11022

Legal name
AXIS COMMUNITY HEALTH INC
Doing business as
AXIS COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 21, 2025
Last certification
Nov 21, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1686 2ND St
Livermore, CA 94550-4328

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Axis Community Health9 organizations share this tax ID, including this one
Part of
Axis Community Health

Other organizations with this tax ID 8

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

Member of 1

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

Locations

1686 2nd St
Livermore, CA 94550
Phone (925) 462-1755

5925 W Las Positas Blvd
Ste 100
Pleasanton, CA 94588
Phone (925) 201-6011

6666 Owens Dr
Pleasanton, CA 94588
Phone (925) 201-6200

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
Carolyn Siegried Individual Corporate DirectorChair Apr 26, 2022
Thelma Fones Individual Corporate DirectorSecretary Dec 26, 2006
Dimple Cyril Individual Corporate DirectorDirector Aug 22, 2023
Mark Eaton Individual Corporate DirectorTreasurer Nov 26, 2002
James Paxson Individual Corporate DirectorVice Chair Mar 28, 2006
Suryanarayana Alapati Individual Corporate DirectorDirector Sep 27, 2022
Farzana Najeeb Individual Corporate DirectorDirector Oct 24, 2006
Gladys Montalvo-Campo Individual Corporate DirectorDirector Jul 28, 2009
Divya T Raviendran Individual Corporate DirectorDirector Nov 29, 2022
Axis Community Health Inc Organization, Pleasanton, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 22, 1972 100%
Elizabeth Perez-Howe Individual Corporate OfficerChief Executive Officer Jun 4, 2022 100%
W-2 Managing EmployeeAd; Jun 4, 2022

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Axis Community HealthPleasanton, CA, CCN 551018 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 22, 1972
Axis Community HealthPleasanton, CA, CCN 751866 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 22, 1972

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1336990506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 W LAS POSITAS BLVD STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1686 SECOND ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504328",
            "telephone_number": "925-462-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS COMMUNITY HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AXIS COMMUNITY HEALTH INC",
        "enumeration_date": "2024-03-27",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ-HOWE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-462-1755"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AXIS COMMUNITY HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.