Family Healthcare Network

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

120000597 Issued in CA

Legal business name

FAMILY HEALTHCARE NETWORK

Practice address

33025 Road 159
Ivanhoe, CA 93235-1234

Phone

(559) 791-1877

Fax

(559) 798-1058

NPI assigned

Jun 26, 2006

Last updated

Oct 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kerry Hydash

Title

President Ceo

Phone

(559) 737-4731

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386670610. Details of each certification follow.

• CCN 051844 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 051844

Legal name

FAMILY HEALTHCARE NETWORK

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 20, 1992

Last certification

Aug 20, 1992

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 29, 1978 in CA

Enrollment address

33025 Road 159
Ivanhoe, CA 93235-1234

Other NPIs on the same Medicare enrollment 35

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

• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pixley, CA
  • NPI 1033661558

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Case Manager/Care Coordinator
  • Tulare, CA
  • NPI 1043664766

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
  • NPI 1053875484

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1073997201

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
  • NPI 1083611156

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1114407244

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1174175012

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1225546575

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1295478212

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1326317819

  O20040123000681

  Same enrollment

Locations

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.

All facility ownership & control disclosures 15

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

Practitioners 233

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.

• Robert M Ayers, MD

  • Obstetrics & Gynecology Physician
  • Visalia, CA
  • NPI 1104842152
  NPD
• Olusayo Olutunde Fadiran, MBBS

  • Internal Medicine Physician
  • Visalia, CA
  • NPI 1770017386
  NPD
• Janice Anne A Matias, PA-C

  • Physician Assistant
  • North Hollywood, CA
  • NPI 1881949808
  NPD
• Adeyimika Omololu, MD

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1265878441
  NPD
• Jandy Le

  • Physician Assistant
  • Mesa, AZ
  • NPI 1316533797
  NPD
• Ruby Loretta Russell, PA-C

  • Physician Assistant
  • Glendale, AZ
  • NPI 1619496999
  NPD
• Adam Ahmed Jr., PA-C

  • Physician Assistant
  • Hanford, CA
  • NPI 1598489114

  Multi-Specialty

  NPD (past)
• Mohammed Asfhan Ahmed, DO

  • Internal Medicine Physician
  • Visalia, CA
  • NPI 1588161483
  NPD (past)
• Henry Asutin Anthony, NP

  • Family Nurse Practitioner
  • Madera, CA
  • NPI 1881081339
  NPD (past)
• Omar Amer Araim, M.D.

  • Vascular Surgery Physician
  • Visalia, CA
  • NPI 1548474570
  NPD (past)
• Esther Avila, PA-C

  • Physician Assistant
  • Corona, CA
  • NPI 1073834065
  NPD (past)
• Vanessa Amanda Banales, PA-C

  • Physician Assistant
  • Visalia, CA
  • NPI 1659043768
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1386670610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-734-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33025 ROAD 159",
            "city": "IVANHOE",
            "state": "CA",
            "postal_code": "932351234",
            "telephone_number": "559-791-1877",
            "fax_number": "559-798-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "HYDASH",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "559-737-4731",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "120000597",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70403F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesus Antonio Duran, PA-C
• Gabriela Granados
• Ivanhoe Drug
• Ivanhoe Pharmacy Inc
• Hailey Avila Peltzer, LMFT
• Elena Patricia Rodriguez, PSY.D.

• Federally Qualified Health Center (FQHC) in Ivanhoe, CA
• Providers in Ivanhoe, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.