United Health Centers of the San Joaquin Valley
Organization Active NPI Federally Qualified Health Center (FQHC) · Clovis, CA
NPI 1629640461 · NPPES record last updated Apr 9, 2025
Key facts
- NPI
- 1629640461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
- Practice address
- 313 W Shaw Ave
Clovis, CA 93612-3685 - Phone
- (559) 646-6618
- NPI assigned
- Jul 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Mary Lou Lopez
- Title
- Director of Billing
- Phone
- (800) 492-4227
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2260238 | United Health Centers of the San Joaquin Valley | Certificate of waiver | May 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Federally qualified health center certification: CCN A01048
- Legal name
- UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 11, 2022
- Last certification
- Feb 11, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 15, 1971 in CA
- Enrollment address
- 313 W Shaw Ave
Clovis, CA 93612-3685
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Esther Nicacio |
Corporate Director |
May 27, 2010 | |
| Manuel a Angulo |
Corporate Director |
Aug 1, 2015 | |
| Daniel T Parra |
Corporate Director |
Mar 1, 2017 | |
| Jesus Rafael Maldonado Hernandez |
Corporate Officer |
Nov 2, 2015 | |
| Ofelia Garcia |
Corporate Director |
Mar 31, 2011 | |
| Sarah Guerra |
Corporate Director |
Jan 1, 2018 | |
| Edna L Avalos |
Corporate Director |
Jan 1, 2018 | |
| Nathan Williams |
Corporate Director |
Sep 1, 2018 | |
| John Shantz |
Corporate Director |
Apr 1, 2015 | |
| Navjot Singh |
W-2 Managing Employee |
Jun 11, 2021 | |
| Jose Gutierrez |
Corporate Director |
Aug 1, 2020 | |
| Nicole Thompson |
Corporate Director |
Nov 1, 2020 | |
| Colleena L Curtis |
Corporate Officer |
Nov 17, 2021 | |
| Justin W Preas |
Corporate Officer |
Apr 25, 2005 |
All facility ownership & control disclosures 7
| Facility | Type | Role | Since |
|---|---|---|---|
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 21, 2012 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control | Jun 23, 2014 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control | Apr 10, 2023 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control | Dec 8, 2015 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control | Feb 28, 2018 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control | Apr 19, 2018 |
| United Health Centers of the San Joaquin Valley |
Federally qualified health center | Operational/Managerial Control (100%) | Sep 15, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220215002346 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 5991727802 | Practice locations: Clovis, CA |
National Provider Directory
- Tax ID family
- United Health Centers of the San Joaquin Valley
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator |
171M00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
313 W Shaw Ave
Clovis, CA 93612-3685
Mailing address
3875 W Beechwood Ave
Fresno, CA 93711-0795
Phone (559) 646-6618
Other providers in Clovis, CA
- Jacqee Dominick Twist I
- Oghogho Uhunmwangho
- Essien Ukpe
- Unaiza Hayat, MD Inc
- Feei Feei Ung
- United Health Centers of the San Joaquin Valley
- Unlimited Caring Group, Inc.
- Caroline Theresa Urbanek
- Elizabeth Urbano
- Gonzalo Urbano
All providers in Clovis, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.