Active NPI
County of Ventura
Doing business as Magnolia West
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- License
- H80CS00247-06-03
- Legal business name
- COUNTY OF VENTURA
- Doing business as
- Magnolia West
- Practice address
- 2220 E Gonzales Rd Ste 120a-B
Oxnard, CA 93036-3707 - Phone
- (805) 981-5151
- Fax
- (805) 981-5150
- NPI assigned
- Apr 9, 2012
- Last updated
- Jul 19, 2024
- Organization subpart
- Yes
- Parent organization
- VENTURA COUNTY MEDICAL CENTER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theresa Cho, MD
- Title
- Director
- Phone
- (805) 677-5290
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | H80CS00247-06-03 | CA | Primary |
Addresses
Primary practice location
2220 E Gonzales Rd Ste 120a-B
Oxnard, CA 93036-3707
Mailing address
800 S Victoria Ave # L4615
Ventura, CA 93009-0003
Phone (805) 677-5210
Other names 1
- Magnolia West
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131202000151 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 7911810171 | Practice locations: Oxnard, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1669738159. Details of each certification follow.
Federally qualified health center certification: CCN 751047
- Legal name
- COUNTY OF VENTURA
- Doing business as
- MAGNOLIA WEST
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 27, 2014
- Last certification
- Jan 27, 2014
- Ownership / control type
- For profit – corporation
- Organization structure
- Other
- Incorporated
- in CA
- Enrollment address
- 2220 E Gonzales Road
Oxnard, CA 93036-0000
Other NPIs with the same Medicare PAC ID 20
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
7911810171
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
7911810171
-
dba Las Islas Mobile
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1154600336
7911810171
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
7911810171
-
dba Conejo Valley Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Thousand Oaks, CA
- NPI 1316188253
7911810171
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
7911810171
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
7911810171
-
dba Public Health Services
- Public Health or Welfare Agency
- Oxnard, CA
- NPI 1528275351
7911810171
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
7911810171
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
7911810171
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
7911810171
National Provider Directory
National Provider Directory- Tax ID family
- Penfield Mtu
- Part of
- Penfield Mtu
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Medical Specialty Clinic/Center
- Ventura, CA
- NPI 1669730271
-
dba VCBH - Simi Valley Youth & Family Mental Health
- Community/Behavioral Health Agency
- Simi Valley, CA
- NPI 1609098243
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
-
dba Medicine Specialty Center West
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619804697
-
dba Public Health TCM Program
- Public Health or Welfare Agency
- Oxnard, CA
- NPI 1649453218
-
dba Magnolia Dental
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1659182988
-
dba Las Islas Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1720447568
-
- Clinical Medical Laboratory
- Oxnard, CA
- NPI 1780762617
-
dba Ventura County Probation Agency
- Urgent Care Clinic/Center
- Oxnard, CA
- NPI 1811883309
-
dba North Oxnard Public Health Clinic
- State or Local Public Health Clinic/Center
- Oxnard, CA
- NPI 1821527326
-
- Dental Clinic/Center
- Ventura, CA
- NPI 1861943805
Locations
2220 E Gonzales Rd
Ste 120AB
Oxnard, CA 93036
Phone (805) 981-5150
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Barry Zimmerman | Corporate Director | Mar 11, 2021 | 100% |
| W-2 Managing Employee | Mar 11, 2021 | ||
| Terry Garman | W-2 Managing Employee | Apr 26, 2022 | |
| County of Ventura | 5% Or Greater Direct Ownership Interest | Jan 1, 2013 | 100% |
Owners & managing parties with NPI records 20
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
5% Or Greater Direct Ownership Interest
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
5% Or Greater Direct Ownership Interest
-
- State or Local Public Health Clinic/Center
- Oxnard, CA
- NPI 1134658644
5% Or Greater Direct Ownership Interest
-
dba Las Islas Mobile
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1154600336
5% Or Greater Direct Ownership Interest
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
5% Or Greater Direct Ownership Interest
-
dba Conejo Valley Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Thousand Oaks, CA
- NPI 1316188253
5% Or Greater Direct Ownership Interest
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
5% Or Greater Direct Ownership Interest
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
5% Or Greater Direct Ownership Interest
-
dba Public Health Services
- Public Health or Welfare Agency
- Oxnard, CA
- NPI 1528275351
5% Or Greater Direct Ownership Interest
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
5% Or Greater Direct Ownership Interest
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
5% Or Greater Direct Ownership Interest
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 17
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ventura County Medical Center | Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 1966 Aug 18, 2010 |
| Magnolia Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Conejo Valley Family Medical Group FQHC | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 29, 1994 |
| Las Islas Family Medical Group North | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Fillmore Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| John K Flynn Community Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Las Posas Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Feb 19, 2014 Jan 1, 2013 |
| Sierra Vista Family Medical Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula Hospital Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Pediatric Diagnostic Center | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula West | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Mar 8, 2013 |
| Moorpark Family Medical Group | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2008 |
| Mandalay Bay Womens & Childrens | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Santa Paula Medical Clinic | Federally qualified health center | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2013 |
| West Ventura Medical Clinic | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Las Islas Family Medical Group II | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Ventura County Healthcare for the Homeless Program | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 24, 2013 |
Owned or controlled facilities with NPI records 17
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
5% Or Greater Direct Ownership Interest
-
dba Conejo Valley Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Thousand Oaks, CA
- NPI 1316188253
5% Or Greater Direct Ownership Interest
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba West Ventura Medical Clinic
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1780821660
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Santa Paula West FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1841431707
5% Or Greater Direct Ownership Interest
Facilities with the same owner 17
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba John K. Flynn Community Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1043451982
County of Ventura
-
dba Fillmore Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Fillmore, CA
- NPI 1134360076
County of Ventura
-
dba Moorpark Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Moorpark, CA
- NPI 1174764021
County of Ventura
-
dba Conejo Valley Family Medical Group FQHC
- Federally Qualified Health Center (FQHC)
- Thousand Oaks, CA
- NPI 1316188253
County of Ventura
-
dba Sierra Vista Family Medical Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Simi Valley, CA
- NPI 1386886117
County of Ventura
-
dba Las Islas Family Medical Group
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1508187329
County of Ventura
-
dba Mandalay Bay Women & Childrens FQHC
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1538300488
County of Ventura
-
dba Santa Paula Hospital Clinic FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1548401409
County of Ventura
-
dba Pediatric Diagnostic Center FQHC
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1619118569
County of Ventura
-
dba Ventura County Medical Center
- General Acute Care Hospital
- Ventura, CA
- NPI 1629167457
County of Ventura
-
dba West Ventura Medical Clinic
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1780821660
County of Ventura
-
dba Santa Paula West FQHC
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1841431707
County of Ventura
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333929600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1721347200000",
"number": "1669738159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S VICTORIA AVE # L4615",
"city": "VENTURA",
"state": "CA",
"postal_code": "930090003",
"telephone_number": "805-677-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 E GONZALES RD STE 120A-B",
"city": "OXNARD",
"state": "CA",
"postal_code": "930363707",
"telephone_number": "805-981-5151",
"fax_number": "805-981-5150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF VENTURA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VENTURA COUNTY MEDICAL CENTER",
"enumeration_date": "2012-04-09",
"last_updated": "2024-07-19",
"certification_date": "2024-07-19",
"status": "A",
"authorized_official_last_name": "CHO",
"authorized_official_first_name": "THERESA",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "805-677-5290",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CA",
"license": "H80CS00247-06-03",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Magnolia West",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Magnolia West",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oxnard, CA
- County of Ventura (Public Health Services)
- County of Ventura (Mandalay Bay Women & Childrens FQHC)
- County of Ventura (South Oxnard Public Health Clinic)
- County of Ventura (Public Health TCM Program)
- County of Ventura (Magnolia Dental)
- County of Ventura (Las Islas Family Medical Group FQHC)
- County of Ventura
- County of Ventura
- County of Ventura (Ventura County Probation Agency)
- County of Ventura (North Oxnard Public Health Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.