NPIMap

Organization Active NPI

East Valley Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • La Puente, CA
National Provider Identifier
1598007197
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
960000210 Issued in CA
Legal business name
EAST VALLEY COMMUNITY HEALTH CENTER, INC.
Practice address
14101 Nelson Ave
La Puente, CA 91746-2640
Phone
(626) 919-4333
Fax
(626) 919-2084
NPI assigned
Mar 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Alicia Mardini
Title
Chief Executive Officer
Phone
(626) 919-4333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 960000210 CA Primary

Addresses

Primary practice location

14101 Nelson Ave
La Puente, CA 91746-2640

Mailing address

420 S Glendora Ave
West Covina, CA 91790-3001
Phone (626) 919-4333

Other names 1

  • EVCHC - Willow Center Other name

National Provider Directory

National Provider Directory
Tax ID family
East Valley Community Health Center Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

14101 Nelson Ave
La Puente, CA 91746
Phone (425) 318-2081

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1598007197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "626-919-4333",
            "fax_number": "626-919-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 NELSON AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462640",
            "telephone_number": "626-919-4333",
            "fax_number": "626-919-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "MARDINI",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "626-919-4333"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "960000210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVCHC - Willow Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.