NPIMap

Organization Active NPI

Camarena Health

Doing business as Camarena Health- Tesoro Viejo

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
National Provider Identifier
1346955382
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAMARENA HEALTH
Doing business as
Camarena Health- Tesoro Viejo
Practice address
4148 Town Center Blvd
Madera, CA 93636
Phone
(559) 664-4000
NPI assigned
Jan 13, 2023
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMARENA HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Christine N. Howland
Title
Chief Operations Officer
Phone
(559) 664-4000

Specialties & licenses 1

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

Addresses

Primary practice location

4148 Town Center Blvd
Madera, CA 93636

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Other names 1

  • Camarena Health- Tesoro Viejo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230323002329 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Madera, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346955382. Details of each certification follow.

Federally qualified health center certification: CCN A01810

Legal name
CAMARENA HEALTH
Doing business as
CAMARENA HEALTH-TESORO VIEJO
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 6, 2023
Last certification
Mar 6, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
4148 Town Center Blvd
Madera, CA 93636

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2286729Camarena Health-Tesoro Viejo4148 Town Center Blvd, Madera, CA 93636Certificate of waiverAug 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Darin M Camarena Health25 organizations share this tax ID, including this one
Part of
Darin M Camarena Health

Other organizations with this tax ID 24

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

View all 24

Locations

4148 Town Center Blvd
Madera, CA 93636

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patty Thompson Individual Corporate DirectorBoard Member Dec 1, 2023
Martha Cardona Individual Corporate DirectorBoard Member Vice President May 23, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Jul 16, 2013
Paulo a Soares Individual Corporate OfficerChief Executive Officer Dec 31, 2012
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member President Dec 13, 2012
Seann Garcia Individual Corporate DirectorBoard Member Dec 13, 2012
Virginia M Lane-Pacheco Individual Corporate DirectorBoard Member Jan 1, 2025
Oracio M Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2025
Abimael Vargas Individual Corporate DirectorBoard Member Dec 13, 2012
Christine N Howland Individual Corporate OfficerChief Operations Officer Dec 13, 2012
W-2 Managing EmployeeChief Operations Officer Dec 13, 2012
Raquel Rodarte Individual Corporate DirectorBoard Member Secretary Jan 1, 2015
Bruce Alamedia Individual Corporate DirectorBoard Treasurer Jan 1, 2022

NPI Registry JSON

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1346955382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4148 TOWN CENTER BLVD",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "93636",
            "telephone_number": "559-664-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMARENA HEALTH",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "HOWLAND",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "559-664-4000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camarena Health- Tesoro Viejo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.