NPIMap

Organization Active NPI

Los Angeles Christian Health Centers

Doing business as Los Angeles Christian Health Centers - Pico Aliso

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1457599631
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550000850 Issued in CA
Legal business name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Doing business as
Los Angeles Christian Health Centers - Pico Aliso
Practice address
1625 E 4TH Street
Los Angeles, CA 90033
Phone
(323) 268-8391
Fax
(323) 268-8014
NPI assigned
Jan 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Sarah HoussayniNPI 1346214558
Title
Cmo
Phone
(213) 893-1960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Voluntary or Charitable Agency 251V00000X
Supports Brokerage Agency 251X00000X
Federally Qualified Health Center (FQHC) 261QF0400X 550000850 CA Primary

Addresses

Primary practice location

1625 E 4TH Street
Los Angeles, CA 90033

Mailing address

315 W 9TH St
Los Angeles, CA 90015-1512
Phone (213) 893-1960

Other identifiers 1

IdentifierTypeStateIssuer
1457599631MedicaidCA

Other names 1

  • Los Angeles Christian Health Centers - Pico Aliso Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090731000455 CA Part A Provider - Federally Qualified Health Center (FQHC) 8224114210 Practice locations: Los Angeles, CA

Federally qualified health center certification: CCN 051195

Legal name
LOS ANGELES CHRISTIAN HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 5, 2009
Last certification
Aug 5, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 26, 1977 in CA
Enrollment address
1625 E 4TH St
Los Angeles, CA 90033-4201

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Los Angeles Christian Health Centers14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

202 W 1st St
Ste 40435
Los Angeles, CA 90012

315 W 9th St
Los Angeles, CA 90015

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Stacy Bolden-Bowers Individual Corporate OfficerBoard Chair Sep 1, 2019
Corporate DirectorBoard Member Aug 1, 2017
Wayne T Aoki Individual Corporate OfficerBoard Secretary Jul 1, 2022
Corporate DirectorBoard Member Oct 1, 2019
Troy Vaughn Individual Corporate DirectorBoard Member Dec 1, 2022
Terrye Finley Individual Corporate DirectorBoard Member Apr 1, 2012
Kim Mealy Individual Corporate DirectorBoard Member Aug 1, 2020
John J Hong Individual Corporate Director Jul 27, 2009
Kendell Simmons Individual Corporate OfficerBoard Treasurer Jul 1, 2022
Corporate DirectorBoard Member Dec 1, 2020
Kenneth Towler Individual Corporate DirectorBoard Member Mar 1, 2022
Bettina Hubbard-Lewis Individual W-2 Managing EmployeeChief Executive Officer Jan 1, 2013 100%
Edgar D Barron Individual Corporate DirectorBoard Member Oct 1, 2019
Linda Trelles Individual Corporate DirectorBoard Member Sep 1, 2015
Edward Seungse Lee Individual Corporate Director Jul 27, 2009
Stephen Kennedy Individual Corporate OfficerChief Financial Officer Sep 25, 2019 100%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1457599631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 9TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151512",
            "telephone_number": "213-893-1960",
            "fax_number": "213-229-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 4TH STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-268-8391",
            "fax_number": "323-268-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES CHRISTIAN HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-27",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "HOUSSAYNI",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "213-893-1960"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550000850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457599631",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Angeles Christian Health Centers - Pico Aliso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.