Omni Family Health

Organization Active NPI Federally Qualified Health Center (FQHC) · Shafter, CA

NPI 1366463085 · NPPES record last updated Jul 8, 2025

Key facts

NPI
1366463085
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
120000652 (CA)
Legal business name
OMNI FAMILY HEALTH
Practice address
655 S. Central Valley Hwy
Shafter, CA 93263-2790
Phone
(866) 707-6664
Fax
(661) 746-9197
NPI assigned
Jul 21, 2006
Organization subpart
No

Authorized official

Name
Mr. Francisco L Castillon
Title
Chief Executive Officer
Phone
(661) 630-7045

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CA, WI

Federally qualified health center certification: CCN 551849

Legal name
OMNI FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 15, 1998
Last certification
Jul 15, 1998
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Jan 9, 1978 in CA
Enrollment address
655 S Central Valley Hwy
Shafter, CA 93263-2790

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Susan Watkins
Individual
Corporate Officer
Board Member
Nov 5, 2013
David Brust
Individual
Corporate Officer
Board Member
Aug 8, 2016
Francisco L Castillon
Individual
Corporate Officer
Chief Executive Officer
Oct 1, 2010
W-2 Managing Employee
Chief Executive Officer
Oct 1, 2010
Operational/Managerial Control Oct 1, 2010
Manuel Flores
Individual
Corporate Officer
Board Member
Aug 4, 2015
Ruben Garcia
Individual
Corporate Officer
Board Member
Oct 1, 2019
Richard Sepulveda
Individual
Corporate Officer
Board Member
Feb 6, 2018
Kassandra Biviano
Individual
Corporate Officer
Board Member
Dec 7, 2021
Irma Montemayor
Individual
Corporate Officer
Board Member
Jan 12, 2021
John Sanchez
Individual
Corporate Officer
Board Member
Dec 7, 2021
Yolanda a Serna
Individual
Corporate Officer
Board Member
Jun 10, 2014
William Nyitray
Individual
Corporate Officer
Board Member
Nov 7, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050411000986 CA Part B Supplier - Clinic/Group Practice 9234176363 Receives reassigned benefits from 185 practitioners
42 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fresno, CA; Hanford, CA; Lindsay, CA; Lost Hills, CA; Reedley, CA; Ridgecrest, CA; Shafter, CA; Taft, CA…
O20100812000456 WI Part a Provider - Federally Qualified Health Center (FQHC) 9234176363 Practice locations: Shafter, CA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X
Case Manager/Care Coordinator
Group: 193200000X MULTI-SPECIALTY GROUP
171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X 120000652 CA Yes

Addresses

Primary practice location

655 S. Central Valley Hwy
Shafter, CA 93263-2790

Mailing address

4900 California Ave
400B
Bakersfield, CA 93309-7081
Phone (661) 459-1900

Other identifiers

IdentifierTypeStateIssuer
HAP70965FOtherCADHCS/FAMILY PACT
FHC70965FMedicaidCA

Other names

  • National Health Services, Inc Former legal business name

Other providers in Shafter, CA

All providers in Shafter, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.