NPIMap

Organization Active NPI

Arroyo Vista Family Health Foundation

Doing business as Arroyo Vista Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1447353701
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
960001394 Issued in CA
Legal business name
ARROYO VISTA FAMILY HEALTH FOUNDATION
Doing business as
Arroyo Vista Family Health Center
Practice address
6000 N Figueroa Street
Los Angeles, CA 90042-4232
Phone
(323) 254-5291
Fax
(323) 254-4618
NPI assigned
Sep 5, 2006
Last updated
Jan 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Mrs. Lorraine Estradas, M.P.H., RN
Title
Chief Executive Officer
Phone
(323) 254-5291

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 960001394 CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

6000 N Figueroa Street
Los Angeles, CA 90042-4232

Mailing address

6000 N Figueroa Street
Los Angeles, CA 90042-4232
Phone (323) 254-5291

Other identifiers 1

IdentifierTypeStateIssuer
FHC70071FMedicaidCA

Other names 1

  • Arroyo Vista Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041203000824 CA Part B Supplier - Clinic/Group Practice 2264498930 Receives reassigned benefits from 62 practitioners
4 other NPIs on this enrollment
Practice locations: Los Angeles, CA
O20110127000663 CA Part A Provider - Federally Qualified Health Center (FQHC) 2264498930 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447353701. Details of each certification follow.

Federally qualified health center certification: CCN 051811

Legal name
ARROYO VISTA FAMILY HEALTH FOUNDATION
Doing business as
ARROYO VISTA FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 11, 1980 in CA
Enrollment address
6000 N Figueroa St
Los Angeles, CA 90042-4232

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
John L Ansaldo Individual Corporate OfficerChief Financial Officer Jun 28, 2012
Sergio Tejadilla Individual Corporate DirectorBoard Member Jun 27, 1997
J Lorraine Estradas Individual Corporate OfficerChief Executive Officer Mar 10, 1984 100%
W-2 Managing EmployeeChief Executive Officer May 6, 2015
Carlos Zaragoza Individual Corporate DirectorBoard Member Apr 12, 1984
Daniel Garrett Individual Corporate DirectorBoard Member Jan 26, 2016
Thuy Q Pham Individual Corporate OfficerChief Medical Officer Jun 28, 2012
Maria del Rosario Martinez Individual Corporate DirectorBoard Member Oct 25, 2012
Roger Estrada Individual Corporate DirectorBoard Member Apr 25, 1997
Peter Fernandez Individual Corporate DirectorBoard Member Nov 20, 2014
Rachel Lopez-Kinney Individual Corporate DirectorBoard Member Oct 23, 1997

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 64

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.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1447353701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 N FIGUEROA STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424232",
            "telephone_number": "323-254-5291",
            "fax_number": "323-254-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N FIGUEROA STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424232",
            "telephone_number": "323-254-5291",
            "fax_number": "323-254-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROYO VISTA FAMILY HEALTH FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "ESTRADAS",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-254-5291",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.P.H., RN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "960001394",
            "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": "FHC70071F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arroyo Vista Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arroyo Vista Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.