NPIMap

Organization Active NPI

The West Oakland Health Council

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
National Provider Identifier
1700906757
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
140000311 Issued in CA
Legal business name
THE WEST OAKLAND HEALTH COUNCIL
Practice address
10615 International Blvd
Oakland, CA 94603-3805
Phone
(510) 568-9230
Fax
(510) 255-2315
NPI assigned
Mar 30, 2007
Organization subpart
Yes
Parent organization
THE WEST OAKLAND HEALTH COUNCILAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Authorized official

Name
Robert Phillips
Title
Ceo
Phone
(510) 835-9610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 140000311 CA Primary

Addresses

Primary practice location

10615 International Blvd
Oakland, CA 94603-3805

Mailing address

700 Adeline Street
Oakland, CA 94607
Phone (510) 835-9610

Other names 2

  • Albert J. Thomas Medical Clinic Doing business as
  • Baywell Health Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110314000231 CA Part A Provider - Federally Qualified Health Center (FQHC) 9537062302 Practice locations: Oakland, CA
O20120420000113 CA Part B Supplier - Clinic/Group Practice 9537062302 Receives reassigned benefits from 49 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Berkeley, CA; Oakland, CA

Federally qualified health center certification: CCN 551955

Legal name
THE WEST OAKLAND HEALTH COUNCIL
Doing business as
ALBERT J. THOMAS MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 25, 2004
Last certification
Feb 25, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 2, 1968 in CA
Enrollment address
10615 International Blvd
Oakland, CA 94603-3805

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
West Oakland HLTH Counc19 organizations share this tax ID, including this one
Part of
West Oakland HLTH Counc

Other organizations with this tax ID 18

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

View all 18

Locations

10615 International Blvd
Oakland, CA 94603
Phone (510) 568-9230

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
Loyd Ware Individual Corporate DirectorBoard Vice President May 4, 2017
Samson Gerbrekidan Mael Individual W-2 Managing EmployeeCoo Sep 1, 2022
Maribeth Ugalde Individual W-2 Managing EmployeeController Mar 7, 1984
Ingrid Lamirault Individual Corporate DirectorBoard President Apr 27, 2020
Carol Burton Individual Corporate DirectorBoard Treasurer Apr 26, 2020
Michele Antoinette Byrd Individual Corporate DirectorBoard Member Jun 1, 2016
Robert Phillips Individual Corporate OfficerCeo Aug 19, 2022
W-2 Managing EmployeeCeo Aug 19, 2022
Amanda del Carmen Vasquez Individual Corporate DirectorBoard Member Jun 1, 2016
Henry . Davis Individual Corporate DirectorBoard Member Jun 1, 2016
Justus Samuels Individual Corporate DirectorBoard Secretary May 25, 2019

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1700906757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ADELINE STREET",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94607",
            "telephone_number": "510-835-9610",
            "fax_number": "510-272-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10615 INTERNATIONAL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946033805",
            "telephone_number": "510-568-9230",
            "fax_number": "510-255-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WEST OAKLAND HEALTH COUNCIL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE WEST OAKLAND HEALTH COUNCIL",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-835-9610"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "140000311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albert J. Thomas Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Albert J. Thomas Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baywell Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.