NPIMap

Organization Active NPI

JWCH Institute, Inc.

  • Community Health Clinic/Center
  • Palmdale, CA
National Provider Identifier
1780144303
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
JWCH INSTITUTE, INC.
Practice address
2151 E Palmdale Blvd
Palmdale, CA 93550-4037
Phone
(661) 942-2391
NPI assigned
Mar 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Mr. Alvaro P Ballesteros
Title
Chief Executive Officer
Phone
(323) 201-4516

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X
Supports Brokerage Agency 251X00000X
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

2151 E Palmdale Blvd
Palmdale, CA 93550-4037

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

Other names 1

  • Wesley Health Centers - Palmdale Central Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190819001456 CA Part A Provider - Federally Qualified Health Center (FQHC) 1850394123 Practice locations: Palmdale, CA

Federally qualified health center certification: CCN 921169

Legal name
JWCH INSTITUTE INC
Doing business as
WESLEY HEALTH CENTERS - PALMDALE CENTRAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 31, 2020
Last certification
Jan 31, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 4, 1960 in CA
Enrollment address
2151 E Palmdale Blvd
Palmdale, CA 93550-4037

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
05D2167580Wesley Health Centers-Palmdale Central2151 East Palmdale Boulevard, Palmdale, CA 93550Certificate of waiverJun 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wesley Health Centers - Michael Antonovich Dental Clinic68 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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Thomas Grode Individual Corporate DirectorBoard Member Jan 26, 2016
Joseph Castel Individual Corporate DirectorBoard Member - Secretary Mar 6, 2017
Andy Irie Individual Corporate OfficerChief Adminstrative Officer Jan 1, 2010
Paul Gerald Gregerson Individual Corporate OfficerChief Medical Officer Jan 1, 2001
Christopher Ewing Individual Corporate DirectorBoard Member Jun 28, 2022
JWCH Institute Inc Organization, Commerce, CA Operational/Managerial Control Apr 15, 2019 100%
Ana Ortiz Individual Corporate OfficerChief Dental Officer Nov 14, 2016
Jeanne Lam Individual Corporate OfficerChief Financial Officer Jul 1, 2005
Eduardo Saucedo Individual Corporate DirectorBoard Member - Secretary Jul 26, 2016
Tien Dang Individual Corporate OfficerChief Information Officer Apr 30, 2014
Alvaro P Ballesteros Individual Corporate OfficerChief Executive Officer Oct 1, 2003
Herbert Torrence Individual Corporate DirectorBoard Member Feb 28, 2017
Kathleen House Individual Corporate DirectorBoard Member - Chair Nov 22, 2011
Cynthia Lopez Individual Operational/Managerial ControlOffice Administrator/Director of OB Apr 15, 2019
Lawrence Fernandez Individual Corporate DirectorBoard Member Jun 25, 2002
Brenda Velasquez Individual Corporate OfficerChief Operating Officer Jul 19, 2022
Maria a Padron Individual Corporate DirectorBoard Member Feb 14, 2007
Sheila Eaton Individual Corporate DirectorBoard Member - Treasurer Sep 24, 2013
Marie S. Torres Individual Corporate DirectorBoard Member - Vice Chair Apr 26, 2022

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
JWCH Medical Clinic @ Bell ShelterBell, CA, CCN 751883 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2015

Facilities with the same owner 1

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

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1780144303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504037",
            "telephone_number": "661-942-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JWCH INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-201-4516",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wesley Health Centers - Palmdale Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.