NPIMap

Organization Active NPI

Family Health Centers of San Diego, Inc

Doing business as Escondido Physical Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
National Provider Identifier
1356178180
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Doing business as
Escondido Physical Health and Wellness
Practice address
157 E Valley Pkwy Ste 100
Escondido, CA 92025-2762
Phone
(706) 546-2094
Fax
(760) 546-2095
NPI assigned
Sep 16, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Ricardo Roman
Title
Chief Financial Officer
Phone
(619) 906-4603

Specialties & licenses 1

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

Addresses

Primary practice location

157 E Valley Pkwy Ste 100
Escondido, CA 92025-2762

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other names 1

  • ESCONDIDO PHYSICAL HEALTH AND WELLNESS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250414000583 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476446378 Practice locations: Escondido, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356178180. Details of each certification follow.

Federally qualified health center certification: CCN A01949

Legal name
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Doing business as
ESCONDIDO PHYSICAL HEALTH AND WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 11, 2025
Last certification
Mar 11, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
157 E Valley Pkwy
Ste 100
Escondido, CA 92025-2762

National Provider Directory

National Provider Directory
Tax ID family
Logan Heights Family HL118 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

248 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2338

251 Landis Ave
Chula Vista, CA 91910
Phone (619) 515-2500

338 W Lexington Ave
Ste 104
El Cajon, CA 92020
Phone (619) 255-5499

128 N Broadway
Escondido, CA 92025
Phone (760) 546-2858

157 E Valley Pkwy
Ste 100
Escondido, CA 92025
Phone (706) 546-2094

8851 Center Dr
Ste 312
La Mesa, CA 91942
Phone (619) 515-2383

2136 El Cajon Blvd
San Diego, CA 92104
Phone (619) 291-1881

2875 Ocean View Blvd
Ste E128
San Diego, CA 92113
Phone (619) 515-2324

301 22nd St
San Diego, CA 92102
Phone (619) 515-2435

3132 Jefferson St
San Diego, CA 92110
Phone (619) 346-4020

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

5160 Federal Blvd
San Diego, CA 92105
Phone (619) 515-2454

5472 El Cajon Blvd
Ste 101
San Diego, CA 92115
Phone (619) 269-0836

550 Washington St
Ste 201
San Diego, CA 92103
Phone (619) 686-3603

7290 El Cajon Blvd
San Diego, CA 92115
Phone (619) 255-7705

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Ricardo Roman Individual Corporate OfficerChief Financial Officer Sep 20, 2010
Bertha Garcia Individual OtherBoard Member Nov 12, 1992
Mary Teresa Sessom Individual OtherBoard Member Sep 18, 2013
Daniel Guillen Individual OtherBoard Member Jul 24, 2013
Margarita I Carmona Individual OtherBoard Member Aug 21, 1978
Venus F Thomas Individual OtherBoard Member Mar 15, 2000
Sean Mathews Individual OtherBoard Member Jul 24, 2013
Barbara J Carr Individual OtherBoard Member Jun 18, 1997
Jose R de la Garza Individual OtherBoard Member Jul 29, 1985
Frank Espinoza Individual OtherBoard Member Jul 24, 2013
Wayne R Anderson Individual OtherBoard Member Jun 20, 2007
Uyen-Thao Tran Individual W-2 Managing EmployeeMD; Jun 25, 2023
Fran Butler-Cohen Individual Corporate OfficerChief Executive Officer Jan 21, 1986

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1,134

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 1,134

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1356178180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-237-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 E VALLEY PKWY STE 100",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252762",
            "telephone_number": "706-546-2094",
            "fax_number": "760-546-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF SAN DIEGO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "619-906-4603"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ESCONDIDO PHYSICAL HEALTH AND WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ESCONDIDO PHYSICAL HEALTH AND WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.