Family Healthcare Network

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

120000660 Issued in CA

Legal business name

FAMILY HEALTHCARE NETWORK

Practice address

400 East Oak Street
Visalia, CA 93291

Phone

(559) 741-4500

Fax

(559) 741-4502

NPI assigned

Oct 10, 2006

Last updated

Oct 31, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kerry Hydash

Title

President Ceo

Phone

(559) 737-4731

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821186727. Details of each certification follow.

• CCN 551929 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 551929

Legal name

FAMILY HEALTHCARE NETWORK

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Aug 9, 2003

Last certification

Aug 9, 2003

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jun 29, 1976 in CA

Enrollment address

400E Oak Ave
Visalia, CA 93291-5034

Other NPIs on the same Medicare enrollment 35

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

• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pixley, CA
  • NPI 1033661558

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Case Manager/Care Coordinator
  • Tulare, CA
  • NPI 1043664766

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
  • NPI 1053875484

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Tulare, CA
  • NPI 1073997201

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Porterville, CA
  • NPI 1083611156

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1114407244

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1174175012

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1225546575

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1295478212

  O20040123000681

  Same enrollment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1326317819

  O20040123000681

  Same enrollment

All disclosed owners & managing parties 12

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

All facility ownership & control disclosures 15

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

Practitioners 37

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.

• Christina C Agda, LCSW

  • Clinical Social Worker
  • Porterville, CA
  • NPI 1235484817
  NPD
• Ranjeet Singh Arora

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1982100764
  NPD
• Mary Anjielen Arellano Artille, PA-C

  • Physician Assistant
  • Visalia, CA
  • NPI 1457104085
  NPD
• Manivanh M Baum, PA-C

  • Physician Assistant
  • Visalia, CA
  • NPI 1003180191
  NPD
• Sinit Tsegaye Berhe

  • Nurse Practitioner
  • Visalia, CA
  • NPI 1386338515
  NPD
• Anthony D Boxrud, FNP

  • Family Nurse Practitioner
  • Visalia, CA
  • NPI 1316597123
  NPD
• Robert Cardenas, PA-C

  • Physician Assistant
  • Visalia, CA
  • NPI 1497703284
  NPD
• Maryann Andrea Cruz, FNP-C

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1487201331
  NPD
• Jordan Daniels, PA

  • Physician Assistant
  • Visalia, CA
  • NPI 1811478035
  NPD
• Melody Delahoussaye-Turner, O.D.

  • Optometrist
  • North Hollywood, CA
  • NPI 1477804771
  NPD
• Yenifer Duque-Gomez, PA-C

  • Physician Assistant
  • Fresno, CA
  • NPI 1891147286
  NPD
• Elizabeth L Enderton, D.O.

  • Obstetrics & Gynecology Physician
  • Visalia, CA
  • NPI 1780823328
  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1821186727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700",
            "fax_number": "559-734-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 EAST OAK STREET",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "93291",
            "telephone_number": "559-741-4500",
            "fax_number": "559-741-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "HYDASH",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "559-737-4731",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "120000660",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70980F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "managedcare@fhcn.org",
            "affiliation": "N",
            "endpointDescription": "Managed Care",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 East Oak Street",
            "city": "Visalia",
            "state": "CA",
            "country_code": "US",
            "postal_code": "93291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Family Healthcare Network
• Family Healthcare Network
• Family Healthcare Network
• Family Healthcare Network
• Family Healthcare Network
• Family Healthcare Network
• Family Services of Tulare Co.
• Christopher Jarett Fammatre, D.D.S.
• Armin Farajzadeh Deroee, M.D.
• Fareid Dental Corporation (Packwood Creek Dental Group)

• Federally Qualified Health Center (FQHC) in Visalia, CA
• Providers in Visalia, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.