NPIMap

Organization Active NPI

The Childrens Clinic 'Serving Children and Their Families'

  • Community Health Clinic/Center
  • Long Beach, CA
National Provider Identifier
1699839993
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
960001378 Issued in CA
Legal business name
THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'
Practice address
1060 E 70TH St
Long Beach, CA 90805-1008
Phone
(562) 264-4669
Fax
(562) 531-7842
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Jina L. Lawler, MSW
Title
Chief Operation Officer
Phone
(562) 264-3985

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 960001378 CA Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1060 E 70TH St
Long Beach, CA 90805-1008

Mailing address

701 E 28TH St
Suite 200
Long Beach, CA 90806-2759
Phone (562) 264-3985

Other identifiers 1

IdentifierTypeStateIssuer
FHC70991FMedicaidCA

Other names 1

  • TCCFHC in NLB at Hamilton Middle School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070914000675 CA Part A Provider - Federally Qualified Health Center (FQHC) 3870544919 Practice locations: Long Beach, CA

Federally qualified health center certification: CCN 051109

Legal name
THE CHILDREN'S CLINIC SERVING CHILDREN AND THEIR FAMILIES
Doing business as
THE CHILDRENS CLINIC FAMILY HEALTH CENTER IN N. LB AT HAMILTON M.S.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 17, 2007
Last certification
Oct 17, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1939 in CA
Enrollment address
1060 E 70TH St
Long Beach, CA 90805-1008

Other NPIs with the same Medicare PAC ID 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1003350Children'S Clinic Family HLTH Ctr in,the1060 East 70TH Street, Long Beach, CA 90805Certificate of waiverAug 27, 2026

National Provider Directory

National Provider Directory
Tax ID family
The Children'S Clinic Serving Children and Their Families17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

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
Cynthia a. Begazo Individual Corporate OfficerChief Human Resources Officer Sep 28, 2015
Operational/Managerial ControlChief Human Resources Officer Sep 28, 2015
Phansy Peang Individual Corporate Director Sep 12, 2007
Guadalupe Padilla Individual Corporate Director Sep 12, 2007
Harold Milton Vandyke Individual Corporate DirectorBoard Member - President Oct 1, 2015 100%
Andrew Horvath Individual Corporate OfficerChief Information Officer Sep 20, 2006
Operational/Managerial ControlChief Information Officer Sep 20, 2006
Maria Chandler Individual Corporate OfficerChief Medical Officer Sep 12, 2007
Operational/Managerial ControlChief Medical Officer Sep 12, 2007
Jina Lawler Individual Corporate OfficerChief Operations Officer Jun 1, 2008
W-2 Managing EmployeeChief Operations Office Jun 1, 2008
Operational/Managerial ControlChief Operations Officer Jun 1, 2008
Elisa Nicholas Individual Corporate OfficerChief Executive Officer Sep 12, 2007
W-2 Managing EmployeeChief Executive Officer Sep 12, 2007
Operational/Managerial ControlChief Executive Officer Sep 12, 2007
Susan Wise Individual Corporate Director Sep 12, 2007

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1699839993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-264-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 70TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908051008",
            "telephone_number": "562-264-4669",
            "fax_number": "562-531-7842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "LAWLER",
        "authorized_official_first_name": "JINA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF OPERATION OFFICER",
        "authorized_official_telephone_number": "562-264-3985",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "960001378",
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70991F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TCCFHC in NLB at Hamilton Middle School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TCCFHC in NLB at Hamilton Middle School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.