Active NPI
Ole Health
- Federally Qualified Health Center (FQHC)
- American Canyon, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- OLE HEALTH
- Practice address
- 3431 Broadway St Ste A8And9
American Canyon, CA 94503-1228 - Phone
- (707) 254-1770
- Fax
- (707) 254-1779
- NPI assigned
- Nov 1, 2022
- Last updated
- Nov 1, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alicia Hardy
- Title
- Chef Executive Officer
- Phone
- (707) 266-5740
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
3431 Broadway St Ste A8And9
American Canyon, CA 94503-1228
Mailing address
1141 Pear Tree LN
Napa, CA 94558-6484
Phone (707) 254-1774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040427001735 | CA | Part B Supplier - Clinic/Group Practice | 7315934767 |
Receives reassigned benefits from 134 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Napa, CA; Saint Helena, CA; Fairfield, CA; Calistoga, CA; American Canyon, CA |
| O20251230003176 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 7315934767 | Practice locations: American Canyon, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1508573379. Details of each certification follow.
Federally qualified health center certification: CCN A11051
- Legal name
- OLE HEALTH
- Doing business as
- OLE HEALTH AMERICAN CANYON
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 5, 2026
- Last certification
- Jan 5, 2026
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 3431 Broadway St
Ste A8&9
American Canyon, CA 94503-1228
Other NPIs with the same Medicare PAC ID 12
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Davis, CA
- NPI 1558366823
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Woodland, CA
- NPI 1558469064
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1710087515
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1881330579
7315934767
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Ole Health
Other organizations with this tax ID 21
Organizations that report the same tax identification number in the National Provider Directory.
-
dba CommuniCare OLE
- Adolescent and Children Mental Health Clinic/Center
- Woodland, CA
- NPI 1073006607
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1144687955
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1245043165
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1275257826
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
-
dba CommuniCare Family Wellness Center - Unity Building
- Community/Behavioral Health Agency
- Woodland, CA
- NPI 1366091191
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1447687330
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1497130280
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Richmond | Corporate Director | Jul 1, 2017 | |
| Deborah Goodin | Corporate Director | Jun 1, 2021 | |
| Arthur Roosa | Corporate Director | Jun 1, 2019 | |
| Cephas Mugerwa | Corporate Director | Jun 1, 2021 | |
| Andrew Torge | Corporate Officer | Jun 19, 2017 | |
| W-2 Managing Employee | Jun 19, 2017 | ||
| Rosemarie Bautista Macisaac | Corporate Officer | Jun 5, 2023 | |
| W-2 Managing Employee | Jun 5, 2023 | ||
| Alicia F Hardy | Corporate Officer | Jan 9, 2018 | |
| W-2 Managing Employee | Mar 2, 2009 |
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ole Health | Federally qualified health center | Operational/Managerial Control (100%) | Sep 14, 2018 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Clinical Social Worker
- Napa, CA
- NPI 1194908475
-
- Family Medicine Physician
- Napa, CA
- NPI 1558378984
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667260800000",
"number": "1508573379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 PEAR TREE LN",
"city": "NAPA",
"state": "CA",
"postal_code": "945586484",
"telephone_number": "707-254-1774",
"fax_number": "707-254-1779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3431 BROADWAY ST STE A8AND9",
"city": "AMERICAN CANYON",
"state": "CA",
"postal_code": "945031228",
"telephone_number": "707-254-1770",
"fax_number": "707-254-1779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OLE HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A",
"authorized_official_last_name": "HARDY",
"authorized_official_first_name": "ALICIA",
"authorized_official_title_or_position": "CHEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "707-266-5740"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in American Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.