H Street Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

H STREET CLINIC

Doing business as

Central Neighborhood Health Foundation - Upland

Practice address

360 E 7TH St Ste B
Upland, CA 91786-6701

Phone

(909) 981-2509

Fax

(909) 981-2507

NPI assigned

Nov 26, 2019

Last updated

Dec 15, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

550000837As reported in NPPES

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

Authorized official

Name

Eleanor Perez

Title

Coo

Phone

(626) 488-3111

Specialties & licenses 1

Addresses

Other names 1

• Central Neighborhood Health Foundation - Upland Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407492267. Details of each certification follow.

• CCN 921892 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 921892

Legal name

CENTRAL NEIGHBORHOOD HEALTH FOUNDATION UPLAND

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 14, 2020

Last certification

Sep 14, 2020

Ownership / control type

For profit – corporation

Facility address

360 E 7TH Street, Suite B
Upland, CA 91786

Tax ID family

H Street Clinic14 organizations share this tax ID, including this one

Part of

H Street Clinic

Other organizations with this tax ID 13

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

• Central Neighborhood Health Foundat

  dba Central Neighborhood Health Foundation

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1699248674
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Norwalk

  • Community Health Clinic/Center
  • Norwalk, CA
  • NPI 1073259305
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Lucas Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1215706841
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #2

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1265136329
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #3

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1285338475
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #1

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1306540463
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1447872577
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Wilshire

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1457116709
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation Atlantic Clinic

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1518798040
  NPD tax ID
• H Street Clinic

  dba H Street Clinic Coachella

  • Federally Qualified Health Center (FQHC)
  • Coachella, CA
  • NPI 1528653482
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Inglewood

  • Federally Qualified Health Center (FQHC)
  • Inglewood, CA
  • NPI 1548610322
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Wilshire Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1699451153
  NPD tax ID

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1407492267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W OLYMPIC BLVD STE 801",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151440",
            "telephone_number": "213-536-5815",
            "fax_number": "213-478-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E 7TH ST STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866701",
            "telephone_number": "909-981-2509",
            "fax_number": "909-981-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H STREET CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "550000837",
        "enumeration_date": "2019-11-26",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "626-488-3111"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Neighborhood Health Foundation - Upland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carla Mariela Gutierrez
• Diana Gutierrez
• Jorge Andrew Gutierrez
• Leonard Gutierrez Jr.
• H & Y Elderly Care Co.
• Norika JK Haberman, DMD
• Lina Haddadin
• Ghassan Hadi, M.D.
• Mireille Hakimeh, RPH
• Fatima H Hakkak, DO

• Primary Care Clinic/Center in Upland, CA
• Providers in Upland, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.