NPIMap

Organization Active NPI

Altura Centers for Health

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
National Provider Identifier
1689011637
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALTURA CENTERS FOR HEALTH
Practice address
3035 E Bardsley Ave
Tulare, CA 93274-6122
Phone
(559) 686-9097
Fax
(559) 556-0083
NPI assigned
May 31, 2013
Last updated
Jul 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Graciela Soto Perez
Title
Chief Executive Officer
Phone
(559) 685-4601

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

3035 E Bardsley Ave
Tulare, CA 93274-6122

Mailing address

1134 E Cartmill Ave
Tulare, CA 93274
Phone (559) 686-9097

Other identifiers 1

IdentifierTypeStateIssuer
1689011637MedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090115000094 CA Part B Supplier - Clinic/Group Practice 9830103449 Receives reassigned benefits from 58 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tulare, CA; Woodville, CA
O20131207000354 CA Part A Provider - Federally Qualified Health Center (FQHC) 9830103449 Practice locations: Tulare, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689011637. Details of each certification follow.

Federally qualified health center certification: CCN 751034

Legal name
ALTURA CENTERS FOR HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 2, 2013
Last certification
Dec 2, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1996 in CA
Enrollment address
3035 E Bardsley Ave
Tulare, CA 93274-6122

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 7

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

National Provider Directory

National Provider Directory
Tax ID family
Altura Centers for 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.

Locations

3035 E Bardsley Ave
Tulare, CA 93274
Phone (559) 685-4601

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
Graciela Soto Perez Individual Corporate OfficerCeo Aug 9, 2001 100%
Corporate DirectorCeo Aug 9, 2003 100%
W-2 Managing EmployeeCeo Aug 9, 2003 100%
Sesar a Carreno Individual Corporate DirectorVice President Apr 6, 2008
Alda M Noronha Individual Corporate Director Feb 27, 2008
Adrian Holguin Individual Corporate Director Jan 1, 2002
Juan M Mota Individual Corporate OfficerPresident Jan 13, 2018
Corporate DirectorPresident Jan 13, 2018
Patrick Isherwood Individual Corporate Director Aug 24, 2019
Omar Jimenez Individual Corporate Director Aug 24, 2019
Ernestine Dees Individual Corporate DirectorSecretary Oct 1, 2013
Luis R Ruiz Individual Corporate Director Aug 24, 2019
Altura Centers for Health Organization, Tulare, CA Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Oct 16, 1996 100%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Altura Centers for HealthTulare, CA, CCN 551124 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 16, 1996
Altura Centers for HealthWoodville, CA, CCN 751851 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2010
Nov 1, 2010
Nov 1, 2010
West TulareTulare, CA, CCN 751919 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 16, 1996

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 5

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": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1689011637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 E CARTMILL AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "93274",
            "telephone_number": "559-686-9097",
            "fax_number": "559-556-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E BARDSLEY AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932746122",
            "telephone_number": "559-686-9097",
            "fax_number": "559-556-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTURA CENTERS FOR HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "SOTO PEREZ",
        "authorized_official_first_name": "GRACIELA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "559-685-4601"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689011637",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.