Community Well California

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

COMMUNITY WELL CALIFORNIA

Practice address

626 W Lancaster Blvd # 61
Lancaster, CA 93534-3108

Phone

(909) 990-1155

Fax

(424) 361-7766

NPI assigned

Feb 19, 2024

Last updated

Oct 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer R PorterNPI 1700657038

Title

Executive Director

Phone

(909) 419-9278

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Jennifer Renee Porter

  • Community Health Worker
  • Lancaster, CA
  • NPI 1700657038
  NPD Authorized official

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1679338578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W LANCASTER BLVD # 61",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343108",
            "telephone_number": "909-419-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 W LANCASTER BLVD # 61",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935343108",
            "telephone_number": "909-990-1155",
            "fax_number": "424-361-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8599 Haven Ave # 306",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917304849",
            "country_code": "US",
            "telephone_number": "909-990-1155",
            "fax_number": "424-361-7766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 E Main St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934544811",
            "country_code": "US",
            "telephone_number": "805-888-8113",
            "fax_number": "424-361-7766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY WELL CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-419-9278"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700657038",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114749306",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Supports Brokerage Agency in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Supports Brokerage Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.