County of Riverside
Organization Active NPI Federally Qualified Health Center (FQHC) · Banning, CA
NPI 1346353679 · NPPES record last updated Nov 21, 2025
Key facts
- NPI
- 1346353679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 250000534 (CA)
- Legal business name
- COUNTY OF RIVERSIDE
- Practice address
- 940 E Williams St Ste 102
Banning, CA 92220-5848 - Phone
- (951) 849-6794
- Fax
- (951) 849-0060
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Cruikshank, R.N., MSN
- Title
- Chief Executive Officer
- Phone
- (951) 486-6698
Owners & managing parties with NPI records 15
Owned or controlled facilities with NPI records 14
Other NPIs with the same Medicare PAC ID 15
Facilities with the same owner 14
Practitioners 200
-
Aura E Almazan, NP-C
-
Todd A Dawson, M.D.
-
Sarah Duan, DO
-
Guillermo Galvez, FNP-BC
-
Geoffrey Won-Chen Leung, M.D.
-
Tiffany Darlene Mendoza, PA-C
-
Azucena Ruff, FNP
-
Shivang Shah, MD
-
Yuliana Soe, M.D
-
Corinne Verghese, MD
-
Priya Victor, MD
-
Amanda Vo, NP
-
Vivian Acevedo, PA-C
-
Sana Afroz, MD
-
Adolfo Aguilera, MD
-
Katherine Ann Alexander, FNP-C
-
Arthur Amador, MD
-
Margaret Akua Amoo, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 551830
- Legal name
- COUNTY OF RIVERSIDE
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 1, 1997
- Last certification
- Mar 1, 1997
- Ownership / control type
- Non-profit – corporation
- Organization structure
- Government · Non-profit
- Enrollment address
- 940 E Williams St
BLDG 1, Ste 102
Banning, CA 92220-5848
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Jennifer Cruikshank |
Operational/Managerial Control |
Jan 1, 2016 | 100% |
| County of Riverside |
5% Or Greater Direct Ownership Interest | Jul 1, 2012 | 100% |
All facility ownership & control disclosures 14
| Facility | Type | Role | Since |
|---|---|---|---|
| Riverside University Health Systems - Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Mar 31, 1998 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Oct 2, 2006 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2013 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2012 |
| Rubidoux Family Care Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 1, 2014 Mar 1, 2014 |
| Moreno Valley Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 6, 2018 Aug 6, 2018 |
| County of Riverside |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jun 27, 2019 Jun 27, 2016 |
| Main Campus Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 16, 2020 Mar 16, 2020 |
| Main Campus First Floor CHC |
Federally qualified health center | Operational/Managerial Control | Jan 15, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310001107 | CA | Part B Supplier - Clinic/Group Practice | 6507754488 |
Receives reassigned benefits from 362 practitioners This NPI is an additional NPI on the enrollment |
| O20110307000209 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 6507754488 | Practice locations: Banning, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 250000534 | CA | Yes |
Addresses
Primary practice location
940 E Williams St Ste 102
Banning, CA 92220-5848
Mailing address
7888 Mission Grove Pkwy S Ste 120
Riverside, CA 92508-5064
Phone (951) 849-6749
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BCP70723F | Other | CA | CANCER DETECTION PROGRAM |
| HAP70723F | Other | CA | FAMILY PACT |
| FHC70723F | Medicaid | CA |
Other names
- BANNING CHC
- BANNING COMMUNITY HEALTH CENTER
Other providers in Banning, CA
- Janice Cortez
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside
- County of Riverside- Community Health Agency
- County of Riverside-Community Health Agency
- Navi Isabel Covarrubias
All providers in Banning, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.