Family Healthcare Network
Organization Active NPI Federally Qualified Health Center (FQHC) · Fresno, CA
NPI 1346953155 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1346953155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- FAMILY HEALTHCARE NETWORK
- Practice address
- 3425 N First St
Fresno, CA 93726-6821 - Phone
- (877) 960-3426
- NPI assigned
- Dec 27, 2022
- Organization subpart
- No
Authorized official
- Name
- Kerry Hydash
- Title
- President & Ceo
- Phone
- (559) 737-4700
Other NPIs on the same Medicare enrollment 35
Practitioners 2
-
Bryn Ritter, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN A01180
- Legal name
- FAMILY HEALTHCARE NETWORK
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 31, 2023
- Last certification
- Jul 31, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 29, 1978 in CA
- Enrollment address
- 3425 N 1St St
Fresno, CA 93726-6821
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Kerry Hydash |
Corporate Officer |
Apr 23, 2013 | 100% |
| Corporate Director |
Apr 23, 2013 | 100% | |
| W-2 Managing Employee |
Apr 23, 2013 | 100% | |
| Emzy Cope |
Corporate Director | Mar 18, 2006 | |
| Chad Vawter |
Corporate Officer |
Apr 23, 2013 | |
| Michael Botello |
Corporate Director | Mar 18, 2006 | |
| Olivia Gamboa |
Corporate Director |
Feb 15, 2002 | |
| Teresa de la Rosa |
Corporate Director |
Jul 1, 2009 | |
| John Zapalac |
Corporate Director |
Nov 26, 2007 | |
| Minnetta Costa |
Corporate Director | Nov 16, 2011 | |
| Maria Gonzalez |
Corporate Director |
Mar 15, 1988 | |
| Michelle Cano-Dewees |
Corporate Director | Mar 1, 2016 | |
| Sandra Miller |
Corporate Director |
Oct 1, 2014 |
All facility ownership & control disclosures 15
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 29, 2019 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 7, 2019 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 29, 2019 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 20, 2020 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 23, 2019 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 30, 2019 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 9, 2019 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Sep 16, 2019 |
| Family Healthcare Network |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Apr 1, 2013 Mar 1, 2024 |
| Family Healthcare Network |
Federally qualified health center | Operational/Managerial Control (100%) | Jan 30, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000681 | CA | Part B Supplier - Clinic/Group Practice | 6305756339 |
Receives reassigned benefits from 429 practitioners 35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Reedley, CA; Ivanhoe, CA; Selma, CA; Springville, CA; Squaw Valley, CA; Strathmore, CA; Terra Bella, CA; Three Rivers, CA… |
| O20230801001320 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 6305756339 | Practice locations: Fresno, CA |
National Provider Directory
Locations
7060 N Recreation Ave
Ste 101
Fresno, CA 93720
Phone (559) 299-9105
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
3425 N First St
Fresno, CA 93726-6821
Mailing address
305 E Center Ave
Visalia, CA 93291-6331
Phone (559) 737-4700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0-1829 | Other | CA | MEDICARE ID - TYPE UNSPECIFIED |
| ZZZ19552Z | Other | CA | MEDICARE ID - TYPE UNSPECIFIED |
Other providers in Fresno, CA
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All providers in Fresno, 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 Feb 28, 2024. 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.