NPIMap

Organization Active NPI

Axis Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Pleasanton, CA
National Provider Identifier
1669403390
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
A0610721 Issued in CA
Legal business name
AXIS COMMUNITY HEALTH INC
Practice address
4361 Railroad Ave
Pleasanton, CA 94566-6611
Phone
(925) 462-5544
Fax
(925) 201-6016
NPI assigned
Jul 5, 2006
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Elizabeth Perez-Howe
Title
Ceo
Phone
(925) 462-1755

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 140000043 CA
Federally Qualified Health Center (FQHC) 261QF0400X A0610721 CA Primary

Addresses

Primary practice location

4361 Railroad Ave
Pleasanton, CA 94566-6611

Mailing address

5925 W Las Positas Blvd Ste 100
Pleasanton, CA 94588-8537
Phone (925) 462-1755

Other identifiers 1

IdentifierTypeStateIssuer
FHC11593FMedicaidCA

Other names 1

  • AXIS COMMUNITY HEALTH Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041222000621 CA Part B Supplier - Clinic/Group Practice 7012975071 Receives reassigned benefits from 18 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pleasanton, CA
O20100325000978 CA Part A Provider - Federally Qualified Health Center (FQHC) 7012975071 Practice locations: Pleasanton, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669403390. Details of each certification follow.

Federally qualified health center certification: CCN 551018

Legal name
AXIS COMMUNITY HEALTH INC
Doing business as
AXIS COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 12, 2010
Last certification
Feb 12, 2010
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Apr 22, 2004 in CA
Enrollment address
4361 Railroad Ave
Pleasanton, CA 94566-6611

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Axis Community Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thelma Fones Individual Corporate DirectorBoard Secretary Dec 1, 2006
Mark Eaton Individual Corporate DirectorBoard Vice Chair Feb 12, 2010
James Paxson Individual Corporate DirectorBoard Chair Feb 12, 2010
Axis Community Health Inc Organization, Pleasanton, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 22, 1972 100%
Elizabeth Perez-Howe Individual Corporate OfficerCeo Jun 4, 2022 100%
Michael Mandelkow Individual Operational/Managerial Control Feb 11, 2019

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Axis Community HealthPleasanton, CA, CCN 751866 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 22, 1972
Axis Community HealthLivermore, CA, CCN A11022 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 22, 1972

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1669403390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 W LAS POSITAS BLVD STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888537",
            "telephone_number": "925-462-1755",
            "fax_number": "925-417-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4361 RAILROAD AVE",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666611",
            "telephone_number": "925-462-5544",
            "fax_number": "925-201-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS COMMUNITY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ-HOWE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-462-1755"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "140000043",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "A0610721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC11593F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AXIS COMMUNITY HEALTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.