NPIMap

Organization Active NPI

Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Chowchilla, CA
National Provider Identifier
1447309885
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550000137 Issued in CA
Legal business name
CAMARENA HEALTH
Practice address
300 Prosperity Blvd
Chowchilla, CA 93610-8498
Phone
(559) 664-4000
Fax
(559) 675-5625
NPI assigned
Jan 8, 2007
Last updated
Jul 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Authorized official

Name
Mr. Paulo A Soares
Title
Chief Executive Officer
Phone
(559) 664-4000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 550000137 CA Primary
Clinical Social Worker 1041C0700X
General Practice Dentistry 1223G0001X
Dental Assistant 126800000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

300 Prosperity Blvd
Chowchilla, CA 93610-8498

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Other identifiers 3

IdentifierTypeStateIssuer
FHC71114FOtherCAMEDICAL
BCP71114FOtherCAMEDICAL
HAP71114FOtherCAMEDICAL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318000523 CA Part B Supplier - Clinic/Group Practice 4880584317 Receives reassigned benefits from 178 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA
O20050907000199 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Chowchilla, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447309885. Details of each certification follow.

Federally qualified health center certification: CCN 051027

Legal name
CAMARENA HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 7, 2005
Last certification
Dec 7, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
300 Prosperity Blvd
Chowchilla, CA 93610-8498

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

Other NPIs on the same Medicare enrollment 16

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

View all 16

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
05D1055837Camarena Health300 Prosperity Blvd, Chowchilla, CA 93610Provider-performed microscopyDec 28, 2026

National Provider Directory

National Provider Directory

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
Patty Thompson Individual Corporate DirectorBoard Member Dec 1, 2023
Martha Cardona Individual Corporate DirectorBoard Member Vice President May 23, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Jan 24, 2011
Paulo a Soares Individual Corporate DirectorChief Executive Director Feb 1, 2011
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member President Feb 1, 2011
Seann Garcia Individual Corporate DirectorBoard Member Jan 24, 2011
Virginia M Lane-Pacheco Individual Corporate DirectorBoard Member Jan 1, 2025
Oracio M Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2025
Abimael Vargas Individual Corporate DirectorBoard Member Jan 24, 2011
Christine N Howland Individual Corporate OfficerChief Operations Officer Apr 11, 2011 25%
W-2 Managing EmployeeChief Operations Officer Apr 11, 2011 25%
Raquel Rodarte Individual Corporate DirectorBoard Member Secretary Dec 1, 2023
Bruce Alamedia Individual Corporate DirectorBoard Treasurer Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 10

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1447309885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PROSPERITY BLVD",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936108498",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "SOARES",
        "authorized_official_first_name": "PAULO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "559-664-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000137",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC71114F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "BCP71114F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "HAP71114F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chowchilla, CA

Sources for this page

Verify at the official NPI Registry.