NPIMap

Organization Active NPI

Free Clinic of Simi Valley

  • Voluntary or Charitable Agency
  • Simi Valley, CA
National Provider Identifier
1710438197
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
050000088 Issued in CA
Legal business name
FREE CLINIC OF SIMI VALLEY
Practice address
2060 Tapo St
Simi Valley, CA 93063-3417
Phone
(805) 522-3733
NPI assigned
Oct 20, 2016
Last updated
Oct 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Authorized official

Name
Mr. Fred Bauermeister
Title
Executive Director
Phone
(805) 522-3733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 050000088 CA Primary

Addresses

Primary practice location

2060 Tapo St
Simi Valley, CA 93063-3417

Mailing address

2060 Tapo St
Simi Valley, CA 93063-3417
Phone (805) 522-3733

National Provider Directory

National Provider Directory
Tax ID family
Free Clinic of Simi Valley2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2060 Tapo St
Simi Valley, CA 93063
Phone (805) 522-3733

Practitioners & affiliated clinicians

Practitioners 3

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": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1710438197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 TAPO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633417",
            "telephone_number": "805-522-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 TAPO ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633417",
            "telephone_number": "805-522-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE CLINIC OF SIMI VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "BAUERMEISTER",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "805-522-3733",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "CA",
            "license": "050000088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.