NPIMap

Organization Active NPI

Native American Health Center, Inc

Doing business as Native American Health Center

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
National Provider Identifier
1477250504
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NATIVE AMERICAN HEALTH CENTER, INC
Doing business as
Native American Health Center
Practice address
3124 International Blvd
Oakland, CA 94601-2902
Phone
(510) 485-5924
Fax
(510) 485-5949
NPI assigned
Feb 9, 2023
Last updated
Feb 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Alan Wong
Title
Chief Financial Officer
Phone
(510) 485-5932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3124 International Blvd
Oakland, CA 94601-2902

Mailing address

2920 International Blvd
Oakland, CA 94601-2228
Phone (510) 485-5942

Other identifiers 1

IdentifierTypeStateIssuer
1689863516MedicaidCA

Other names 1

  • Native American Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250326003270 CA Part A Provider - Federally Qualified Health Center (FQHC) 4284697202 Practice locations: Oakland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477250504. Details of each certification follow.

Federally qualified health center certification: CCN A01940

Legal name
NATIVE AMERICAN HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 26, 2025
Last certification
Mar 26, 2025
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Oct 12, 1971 in CA
Enrollment address
3124 International Blvd
Oakland, CA 94601-2902

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Urban Indian Health Boa8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Alan Wong Individual Corporate Officer Oct 1, 2021 100%
Amy Hoang Chuong Individual W-2 Managing Employee Jan 1, 2023 100%
Carmen Foghorn Individual Corporate Director Apr 25, 2024
Natalie Aguilera Individual Corporate OfficerChief Executive Officer Oct 1, 2021 100%
Leander Davenport Individual Corporate Director Jun 26, 2007

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1477250504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012228",
            "telephone_number": "510-485-5942",
            "fax_number": "510-485-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012902",
            "telephone_number": "510-485-5924",
            "fax_number": "510-485-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE AMERICAN HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "510-485-5932"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689863516",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Native American Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.