NPIMap

Organization Active NPI

Lumira Healthcare

Doing business as Livingston Wolves Center

  • Federally Qualified Health Center (FQHC)
  • Livingston, CA
National Provider Identifier
1487012779
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LUMIRA HEALTHCARE
Doing business as
Livingston Wolves Center
Wolves Wellness Center
Practice address
1617 Main St RM 200201
Livingston, CA 95334-1250
Phone
(209) 850-3500
Fax
(209) 850-3499
NPI assigned
Feb 2, 2016
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Leslie T Abasta-Cummings, MPH
Title
Ceo
Phone
(209) 850-3500

Specialties & licenses 1

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

Addresses

Primary practice location

1617 Main St RM 200201
Livingston, CA 95334-1250

Mailing address

600 B St BLDG a-C
Livingston, CA 95334-9593
Phone (209) 850-3500

Other names 2

  • Livingston Wolves Center Doing business as
  • Wolves Wellness 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
O20040426000617 CA Part B Supplier - Clinic/Group Practice 8820084692 Receives reassigned benefits from 81 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Delhi, CA; Hilmar, CA; Hughson, CA; Livingston, CA; Modesto, CA; Patterson, CA; Waterford, CA
O20170613002755 CA Part A Provider - Federally Qualified Health Center (FQHC) 8820084692 Practice locations: Livingston, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487012779. Details of each certification follow.

Federally qualified health center certification: CCN 751970

Legal name
LIVINGSTON COMMUNITY HEALTH
Doing business as
WOLVESS WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 11, 2017
Last certification
May 11, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 15, 2016 in CA
Enrollment address
1617 Main St
Livingston, CA 95334-1250

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Livingston Community Health10 organizations share this tax ID, including this one
Part of
Livingston Community Health

Other organizations with this tax ID 9

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

Locations

1617 Main St
Livingston, CA 95334
Phone (209) 850-2003

1617 Main St
Rm 200201
Livingston, CA 95334

2116 E Orangeburg Ave
Modesto, CA 95355
Phone (209) 529-1709

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
Steve Moeller Individual Corporate DirectorPublic Director Jan 1, 2016
Maryellen Arana Individual Corporate DirectorBoard Chair Jun 1, 2014
Philllip Schiber Individual Corporate DirectorDirector Jan 1, 2017
Jorge Cisneros Individual Corporate DirectorBoard Member Jan 1, 2015
Hilda Pimentel Individual Corporate DirectorConsumer Director Aug 1, 2012
Leslie Abasta-Cummings Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Mar 27, 2012
W-2 Managing EmployeeChief Executive Officer Mar 27, 2012
Operational/Managerial ControlChief Executive Officer Mar 27, 2012 100%
Eva Delong Individual Corporate DirectorSecretary Feb 1, 2014
John Pedrozo Individual Corporate DirectorDirector Jan 1, 2017
David Blevins Individual Corporate DirectorVice Chair Mar 1, 2012
Rosalinda Ruiz Individual Corporate DirectorConsumer Director Jan 1, 2016
Selina de la Pena Individual Corporate OfficerChief Financial Officer Apr 6, 2015
Travis Lake Individual Corporate DirectorConsumer Director Dec 1, 2015

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1487012779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B ST BLDG A-C",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953349593",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 MAIN ST RM 200201",
            "city": "LIVINGSTON",
            "state": "CA",
            "postal_code": "953341250",
            "telephone_number": "209-850-3500",
            "fax_number": "209-850-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMIRA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "ABASTA-CUMMINGS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-850-3500",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livingston Wolves Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wolves Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, CA

Sources for this page

Verify at the official NPI Registry.