NPIMap

Organization Active NPI

United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Corcoran, CA
National Provider Identifier
1558632570
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Practice address
1000 Chittenden Ave
Corcoran, CA 93212-2407
Phone
(800) 492-4227
Fax
(844) 672-9226
NPI assigned
Jan 23, 2012
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Mary Lou Lopez
Title
Director of Billing
Phone
(800) 492-4227

Specialties & licenses 2

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

Addresses

Primary practice location

1000 Chittenden Ave
Corcoran, CA 93212-2407

Mailing address

3875 W Beechwood Ave
Fresno, CA 93711-0795
Phone (559) 646-6618

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120928000455 CA Part A Provider - Federally Qualified Health Center (FQHC) 5991727802 Practice locations: Corcoran, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558632570. Details of each certification follow.

Federally qualified health center certification: CCN 751010

Legal name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 28, 2012
Last certification
Sep 28, 2012
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 15, 1971 in CA
Enrollment address
1000 Chittenden Ave
Corcoran, CA 93212-2407

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2304710United Health Centers of the San1000 Chittenden Avenue, Corcoran, CA 93212Certificate of waiverMay 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Robert Wageneck DO91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1000 Chittenden Ave
Corcoran, CA 93212

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
Esther Nicacio Individual Operational/Managerial Control Feb 21, 2012
United Health Centers of the San Joaquin Valley Organization, Corcoran, CA Operational/Managerial Control Feb 21, 2012 100%
Ofelia Garcia Individual Operational/Managerial Control Feb 21, 2012
Navjot Singh Individual W-2 Managing EmployeeDirector of Managed Care Jun 5, 2017
Justin W Preas Individual Corporate OfficerPresident & Ceo Apr 25, 2005

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
United Health Centers of the San Joaquin ValleyReedley, CA, CCN 751086 Federally qualified health center Operational/Managerial Control Jun 23, 2014
United Health Centers of the San Joaquin ValleyFresno, CA, CCN 751895 Federally qualified health center Operational/Managerial Control Apr 10, 2023
United Health Centers of the San Joaquin ValleyFresno, CA, CCN 751930 Federally qualified health center Operational/Managerial Control Dec 8, 2015
United Health Centers of the San Joaquin ValleySanger, CA, CCN 921076 Federally qualified health center Operational/Managerial Control Feb 28, 2018
United Health Centers of the San Joaquin ValleyLemoore, CA, CCN 921073 Federally qualified health center Operational/Managerial Control Apr 19, 2018
United Health Centers of the San Joaquin ValleyFowler, CA, CCN A01933 Federally qualified health center Operational/Managerial Control (100%) Sep 15, 2016

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1558632570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 W BEECHWOOD AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110795",
            "telephone_number": "559-646-6618",
            "fax_number": "559-646-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHITTENDEN AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932122407",
            "telephone_number": "800-492-4227",
            "fax_number": "844-672-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARY LOU",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "800-492-4227"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corcoran, CA

Sources for this page

Verify at the official NPI Registry.