NPIMap

Organization Active NPI

County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Banning, CA
National Provider Identifier
1346353679
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
250000534 Issued in 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
Last updated
Nov 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Jennifer Cruikshank, R.N., MSN
Title
Chief Executive Officer
Phone
(951) 486-6698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 250000534 CA Primary

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 names 2

  • BANNING CHC Other name
  • BANNING COMMUNITY HEALTH CENTER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346353679. Details of each certification follow.

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
GovernmentNon-profit
Enrollment address
940 E Williams St
BLDG 1, Ste 102
Banning, CA 92220-5848

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

940 E Williams St
Ste 102
Banning, CA 92220
Phone (951) 588-2553

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

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.

NameRoleSinceShare
Jennifer Cruikshank Individual Operational/Managerial ControlCeo Jan 1, 2016 100%
County of Riverside Organization, Riverside, CA 5% Or Greater Direct Ownership Interest Jul 1, 2012 100%

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 14

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

FacilityTypeRoleSince
Riverside University Health Systems - Medical CenterMoreno Valley, CA, CCN 050292 Hospital 5% Or Greater Direct Ownership Interest (100%) Mar 31, 1998
County of RiversideJurupa Valley, CA, CCN 051059 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 2, 2006
County of RiversideHemet, CA, CCN 551829 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideRiverside, CA, CCN 551827 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2013
County of RiversidePerris, CA, CCN 551825 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideCorona, CA, CCN 551824 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversidePalm Springs, CA, CCN 551828 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideLake Elsinore, CA, CCN 551831 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
County of RiversideIndio, CA, CCN 551826 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2012
Rubidoux Family Care CenterRiverside, CA, CCN 751056 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 CenterMoreno Valley, CA, CCN 921147 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 6, 2018
Aug 6, 2018
County of RiversidePerris, CA, CCN 921193 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 CenterMoreno Valley, CA, CCN 921865 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 CHCMoreno Valley, CA, CCN A01872 Federally qualified health center Operational/Managerial Control Jan 15, 2024

Owned or controlled facilities with NPI records 14

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

View all 14

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1346353679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7888 MISSION GROVE PKWY S STE 120",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925085064",
            "telephone_number": "951-849-6749",
            "fax_number": "951-498-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E WILLIAMS ST STE 102",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922205848",
            "telephone_number": "951-849-6794",
            "fax_number": "951-849-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RIVERSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "CRUIKSHANK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "951-486-6698",
        "authorized_official_credential": "R.N., MSN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "250000534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BANNING CHC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BANNING COMMUNITY HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.