NPIMap

Organization Active NPI

JWCH Institute, Inc.

Doing business as JWCH Norwalk Regional Hth Ctr

  • Federally Qualified Health Center (FQHC)
  • Norwalk, CA
National Provider Identifier
1386708634
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550000250 Issued in CA
Legal business name
JWCH INSTITUTE, INC.
Doing business as
JWCH Norwalk Regional Hth Ctr
Practice address
12360 E Firestone Blvd
Norwalk, CA 90650-4324
Phone
(562) 281-0305
Fax
(562) 281-0309
NPI assigned
Dec 21, 2006
Last updated
Feb 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JWCH INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Mr. Alvaro P. Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 550000250 CA
Federally Qualified Health Center (FQHC) 261QF0400X 550000250 CA Primary
Case Manager/Care Coordinator 171M00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

12360 E Firestone Blvd
Norwalk, CA 90650-4324

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other identifiers 1

IdentifierTypeStateIssuer
CMM71151FMedicaidCA

Other names 1

  • JWCH Norwalk Regional Hth Ctr Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060807000476 CA Part B Supplier - Clinic/Group Practice 1850394123 Receives reassigned benefits from 160 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellflower, CA; Downey, CA; Los Angeles, CA; Lynwood, CA; Norwalk, CA
O20100527000567 CA Part A Provider - Federally Qualified Health Center (FQHC) 1850394123 Practice locations: Norwalk, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386708634. Details of each certification follow.

Federally qualified health center certification: CCN 551044

Legal name
JWCH INSTITUTE INC
Doing business as
JWCH NORWALK REGIONAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 27, 2010
Last certification
May 27, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 4, 1960 in CA
Enrollment address
12360 Firestone Blvd
Norwalk, CA 90650-4324

Other NPIs on the same Medicare enrollment 7

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

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
05D1055556JWCH Norwalk Regional Health Center12360 Firestone Blvd, Norwalk, CA 90650Provider-performed microscopyJan 18, 2027
05D1106759JWCH Institute Inc Mobile Testing Unit12360 Firestone Blvd, Norwalk, CA 90650Certificate of waiverOct 20, 2027

National Provider Directory

National Provider Directory
Part of
Wesley Health Centers - Midnight Mission

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
Thomas Grode Individual Corporate DirectorBoard Member Jan 26, 2016
Leticia Ramirez Individual Operational/Managerial ControlClinic Admin May 20, 2009
Joseph Castel Individual Corporate DirectorBoard Member Jul 13, 2004
Andy Irie Individual Corporate OfficerChief Admin Officer Jan 1, 2010
Paul Gerald Gregerson Individual Corporate OfficerCHF Medical Officer Jan 1, 2001
Jeanne Lam Individual Corporate OfficerChief Financial Officer Jul 1, 2005
Alvaro P Ballesteros Individual Corporate OfficerChief Executive Officer Oct 1, 2003
Kathleen House Individual Corporate DirectorBoard Member-Secretary Nov 22, 2011
Silvia Hernandez Individual Corporate DirectorBoard Member Sep 23, 2014
Lawrence Fernandez Individual Corporate DirectorBoard Member-Vice Chair Jun 25, 2002
Maria a Padron Individual Corporate DirectorBoard Member Feb 14, 2007
Sheila Eaton Individual Corporate DirectorBoard Member Sep 24, 2013

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
JWCH Medical Clinic @ Bell ShelterBell, CA, CCN 751883 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2015
Wesley Health Centers - Palmdale CentralPalmdale, CA, CCN 921169 Federally qualified health center Operational/Managerial Control (100%) Apr 15, 2019

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1386708634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 E FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "562-281-0305",
            "fax_number": "562-281-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JWCH INSTITUTE, INC.",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "550000250",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000250",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM71151F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JWCH Norwalk Regional Hth Ctr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JWCH Norwalk Regional Hth Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.