NPIMap

Organization Active NPI

Native American Health Center, Inc

Doing business as Native American Health Center

  • Federally Qualified Health Center (FQHC)
  • San Francisco, CA
National Provider Identifier
1669642914
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
220000207 Issued in CA
Legal business name
NATIVE AMERICAN HEALTH CENTER, INC
Doing business as
Native American Health Center
Practice address
160 Capp St
San Francisco, CA 94110
Phone
(510) 485-5906
Fax
(510) 485-5919
NPI assigned
Mar 3, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Adrian A Marcus-Flores
Title
Credentialing & Licensing Associate
Phone
(510) 485-5906

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CA
Federally Qualified Health Center (FQHC) 261QF0400X 220000207 CA Primary

Addresses

Primary practice location

160 Capp St
San Francisco, CA 94110

Mailing address

3124 International Blvd
Room 314
Oakland, CA 94601-2228
Phone (510) 485-5906

Other names 1

  • Native American Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041110000286 CA Part B Supplier - Clinic/Group Practice 4284697202 Receives reassigned benefits from 71 practitioners
1 other NPI on this enrollment
Practice locations: Oakland, CA; San Francisco, CA
O20120518000485 CA Part A Provider - Federally Qualified Health Center (FQHC) 4284697202 Practice locations: San Francisco, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669642914. Details of each certification follow.

Federally qualified health center certification: CCN 551875

Legal name
NATIVE AMERICAN HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 7, 2000
Last certification
Jul 7, 2000
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 12, 1971 in CA
Enrollment address
160 Capp Street
San Francisco, CA 94110-1210

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Urban Indian Health Boa8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2950 International Blvd
Oakland, CA 94601
Phone (510) 485-5948

3124 International Blvd
Oakland, CA 94601
Phone (510) 434-5300

3124 International Blvd
Ste 314
Oakland, CA 94601

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Charlene Harrison Individual Corporate DirectorSite Director Jun 15, 2012
Alan Wong Individual Corporate OfficerChief of Finance Jan 1, 2021 100%
Roberto Little Cloud Individual Corporate DirectorBoard Member Dec 15, 2000
Martin Waukazoo Individual Corporate OfficerChief Executive Officer Mar 12, 1981
Amy Hoang Chuong Individual W-2 Managing Employee Jan 1, 2023 100%
Ana O'Connor Individual Corporate OfficerChief Operations Officer Feb 6, 2012
Carmen Foghorn Individual Corporate DirectorBoard Member Jul 22, 2013
Darby Price Individual Corporate DirectorBoard Member Aug 24, 2004
Cindi Adams Individual Corporate DirectorBoard Member Dec 11, 1997
Leander Davenport Individual Corporate DirectorBoard Member Jun 26, 2007

Practitioners & affiliated clinicians

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669642914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 INTERNATIONAL BLVD",
            "address_2": "ROOM 314",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012228",
            "telephone_number": "510-485-5906",
            "fax_number": "510-485-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CAPP ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94110",
            "telephone_number": "510-485-5906",
            "fax_number": "510-485-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE AMERICAN HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "MARCUS-FLORES",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING & LICENSING ASSOCIATE",
        "authorized_official_telephone_number": "510-485-5906"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "220000207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Native American Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Native American Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.