NPIMap

Organization Active NPI

St. Jude Neighborhood Health Centers

  • Primary Care Clinic/Center
  • Orange, CA
National Provider Identifier
1568021772
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ST. JUDE NEIGHBORHOOD HEALTH CENTERS
Practice address
1934 E Taft Ave
Orange, CA 92865-4702
Phone
(714) 771-8006
NPI assigned
Jun 11, 2019
Organization subpart
Yes
Parent organization
ST. JUDE NEIGHBORHOOD HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Mr. Timothy Jason Brown
Title
Chief Executive Officer
Phone
(208) 899-9631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1934 E Taft Ave
Orange, CA 92865-4702

Mailing address

731 S Highland Ave
Fullerton, CA 92832-2753

Other names 1

  • La Amistad Mobile Medical Other name

National Provider Directory

National Provider Directory
Tax ID family
St Jude Neighborhood Health Centers8 organizations share this tax ID, including this one
Part of
St Jude Neighborhood Health Centers

Other organizations with this tax ID 7

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

Locations

1934 E Taft Ave
Orange, CA 92865
Phone (714) 771-8006

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1568021772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S HIGHLAND AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 E TAFT AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928654702",
            "telephone_number": "714-771-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE NEIGHBORHOOD HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JUDE NEIGHBORHOOD HEALTH CENTERS",
        "enumeration_date": "2019-06-11",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "208-899-9631",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Amistad Mobile Medical",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "La Amistad Mobile Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.