NPIMap

Organization Active NPI

Bienvenidos Healthy Start Community Clinic at Wilson High School

  • Community Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1629416250
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
960001182 Issued in CA
Legal business name
BIENVENIDOS HEALTHY START COMMUNITY CLINIC AT WILSON HIGH SCHOOL
Practice address
4500 Multnomah St
Los Angeles, CA 90032-3703
Phone
(323) 222-0970
Fax
(323) 222-0878
NPI assigned
Jun 5, 2013
Organization subpart
Yes
Parent organization
BIENVENIDOS CHILDREN'S CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Authorized official

Name
Jacobus Van Der Colff
Title
Chief Financial Officer
Phone
(213) 785-5923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 960001182 CA Primary

Addresses

Primary practice location

4500 Multnomah St
Los Angeles, CA 90032-3703

Mailing address

316 W 2ND St
Suite 800
Los Angeles, CA 90012-3504
Phone (213) 785-5906

Other identifiers 2

IdentifierTypeStateIssuer
05D2050805OtherCACLIA
00343513OtherCACLR

National Provider Directory

National Provider Directory
Tax ID family
Bienvenidos Childrens Center19 organizations share this tax ID, including this one
Part of
Bienvenidos Childrens Center

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1629416250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W 2ND ST",
            "address_2": "SUITE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123504",
            "telephone_number": "213-785-5906",
            "fax_number": "213-785-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MULTNOMAH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900323703",
            "telephone_number": "323-222-0970",
            "fax_number": "323-222-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIENVENIDOS HEALTHY START COMMUNITY CLINIC AT WILSON HIGH SCHOOL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BIENVENIDOS CHILDREN'S CENTER, INC.",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "VAN DER COLFF",
        "authorized_official_first_name": "JACOBUS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "213-785-5923"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "960001182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2050805",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLR",
            "identifier": "00343513",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.