NPIMap

Organization Active NPI

Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
National Provider Identifier
1740923291
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Practice address
157 E Valley Pkwy Ste 200
Escondido, CA 92025-2762
Phone
(760) 546-2838
Fax
(619) 255-7954
NPI assigned
Apr 13, 2022
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Ricardo Roman
Title
Chief Financial Officer
Phone
(619) 906-4603

Specialties & licenses 1

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

Addresses

Primary practice location

157 E Valley Pkwy Ste 200
Escondido, CA 92025-2762

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other names 1

  • ESCONDIDO FAMILY COUNSELING CENTER Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221003002839 CA Part A Provider - Federally Qualified Health Center (FQHC) 3476446378 Practice locations: Escondido, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740923291. Details of each certification follow.

Federally qualified health center certification: CCN A01119

Legal name
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Doing business as
ESCONDIDO FAMILY COUNSELING CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 6, 2022
Last certification
Oct 6, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 23, 1973 in CA
Enrollment address
157 E Valley Pkwy
Escondido, CA 92025-2762

National Provider Directory

National Provider Directory
Tax ID family
Diamond Neighborhoods Family Health Center Building a119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

157 E Valley Pkwy
Escondido, CA 92025
Phone (760) 546-2838

157 E Valley Pkwy
Ste 200
Escondido, CA 92025
Phone (619) 515-2578

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Ricardo Roman Individual Corporate OfficerChief Financial Officer Sep 20, 2010
Bertha Garcia Individual Corporate DirectorBoard Member Nov 12, 1992
Mary Teresa Sessom Individual Corporate DirectorBoard Member Sep 18, 2013
Daniel Guillen Individual Corporate DirectorBoard Member Jul 24, 2013
Margarita I Carmona Individual Corporate DirectorBoard Member Aug 21, 1978
Venus F Thomas Individual Corporate DirectorBoard Member Mar 15, 2000
Sean Mathews Individual Corporate DirectorBoard Member Jul 24, 2013
Barbara J Carr Individual Corporate DirectorBoard Member Jun 18, 1997
Jose R de la Garza Individual Corporate DirectorBoard Member Jul 29, 1985
Frank Espinoza Individual Corporate DirectorBoard Member Jul 24, 2013
Christopher Gordon Individual W-2 Managing EmployeeMedical Director Sep 17, 2016
Wayne R Anderson Individual Corporate DirectorBoard Member Jun 20, 2007
Fran Butler-Cohen Individual Corporate OfficerPresident & Ceo Jan 21, 1986

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1740923291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-237-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 E VALLEY PKWY STE 200",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920252762",
            "telephone_number": "760-546-2838",
            "fax_number": "619-255-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF SAN DIEGO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "619-906-4603"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ESCONDIDO FAMILY COUNSELING CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "ESCONDIDO FAMILY COUNSELING CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.