NPIMap

Organization Active NPI

Community Health Systems, Inc.

Doing business as Moreno Valley Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Moreno Valley, CA
National Provider Identifier
1679749501
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH SYSTEMS, INC.
Doing business as
Moreno Valley Family Health Center
Practice address
22675 Alessandro Blvd
Moreno Valley, CA 92553-8551
Phone
(951) 571-2350
Fax
(951) 571-2370
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Lori Holeman
Title
Ceo
Phone
(951) 571-2300

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 40093 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 27343 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 46894 CA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 47987 CA
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPT5169TPA CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A99343 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 550000802 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 6440 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A50693 CA
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 11428 CA
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 10648 CA
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 436046 CA

Addresses

Primary practice location

22675 Alessandro Blvd
Moreno Valley, CA 92553-8551

Mailing address

7880 Mission Grove Pkwy S
Riverside, CA 92508-6000
Phone (951) 571-2300

Other identifiers 1

IdentifierTypeStateIssuer
NPI 1679749501MedicaidCA

Other names 1

  • Moreno Valley Family 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
O20051117000822 CA Part B Supplier - Clinic/Group Practice 7012824717 Receives reassigned benefits from 84 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomington, CA; Fallbrook, CA; Moreno Valley, CA; Riverside, CA
O20090806000447 CA Part A Provider - Federally Qualified Health Center (FQHC) 7012824717 Practice locations: Moreno Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679749501. Details of each certification follow.

Federally qualified health center certification: CCN 051192

Legal name
COMMUNITY HEALTH SYSTEMS INC
Doing business as
MORENO VALLEY FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 29, 2009
Last certification
Sep 29, 2009
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 17, 1984 in CA
Enrollment address
22675 Alessandro Blvd
Moreno Valley, CA 92553-8551

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Community Health Systems

Locations

22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Rodger Lehl Individual Corporate Director Feb 24, 2009
Draymond Crawford Individual Corporate Director Sep 15, 2008
Vanessa I Ortiz Individual W-2 Managing EmployeeSenior Executive Assistant Aug 16, 2015
Yolanda Gomez Individual Corporate Director Apr 5, 2005
W-2 Managing Employee Sep 15, 2008
Oscar Ulric Jones Individual Corporate Director Sep 15, 2009
Naomi Dearmore Individual W-2 Managing Employee Apr 1, 2008
Annie Thao Nguyen Individual Corporate OfficerCfo Mar 1, 2018
Linda Prieto Individual W-2 Managing Employee Sep 28, 2011
Lori Holeman Individual Corporate OfficerCeo Sep 15, 2008
Operational/Managerial ControlCeo Aug 11, 2008

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Magnolia Community Health CenterRiverside, CA, CCN 751009 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2012
University Community Heath CenterRiverside, CA, CCN 751025 Federally qualified health center Operational/Managerial Control (100%) Oct 9, 2025
Bloomington Community Health Center- Building 2Bloomington, CA, CCN 921140 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 14, 2024
Jun 14, 2024

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1679749501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7880 MISSION GROVE PKWY S",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925086000",
            "telephone_number": "951-571-2300",
            "fax_number": "951-200-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22675 ALESSANDRO BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538551",
            "telephone_number": "951-571-2350",
            "fax_number": "951-571-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "HOLEMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-571-2300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40093",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "27343",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46894",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "47987",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT5169TPA",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A99343",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "550000802",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "6440",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A50693",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "11428",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "10648",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "436046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPI 1679749501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moreno Valley Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moreno Valley Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.