NPIMap

Organization Active NPI

Ampla Health

Doing business as Ampla Health Yuba City

  • Federally Qualified Health Center (FQHC)
  • Yuba City, CA
National Provider Identifier
1831115070
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
230000280 Issued in CA
Legal business name
AMPLA HEALTH
Doing business as
Ampla Health Yuba City
Practice address
1000 Sutter St
Yuba City, CA 95991-3459
Phone
(530) 673-9420
Fax
(530) 673-9451
NPI assigned
Jul 14, 2006
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Mr. Benjamin H Flores, MPH
Title
President, Chief Executive Officer
Phone
(530) 751-3778

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 230000280 CA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

1000 Sutter St
Yuba City, CA 95991-3459

Mailing address

PO Box Ad
Yuba City, CA 95992-1396
Phone (530) 751-3778

Other identifiers 4

IdentifierTypeStateIssuer
BCP70718FOtherCAEWC:CDP:BCEDP
EAP70718FOtherCAEXPANDED ACCESS TO PRIMARY CARE
3883930MedicaidCA
FHC70718FMedicaidCA

Other names 2

  • Ampla Health Yuba City Doing business as
  • AMPLA HEALTH YUBA CITY MEDICAL Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040225001116 CA Part B Supplier - Clinic/Group Practice 5092619270 Receives reassigned benefits from 154 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yuba City, CA; Chico, CA; Oroville, CA; Orland, CA; Olivehurst, CA; Los Molinos, CA; Hamilton City, CA; Gridley, CA…
O20060201000757 CA Part A Provider - Federally Qualified Health Center (FQHC) 5092619270 Practice locations: Yuba City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831115070. Details of each certification follow.

Federally qualified health center certification: CCN 551821

Legal name
AMPLA HEALTH
Doing business as
AMPLA HEALTH YUBA CITY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 1997
Last certification
Mar 28, 1997
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1973 in CA
Enrollment address
1000 Sutter St
Yuba City, CA 95991-3459

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Locations

2800 Lincoln St
Oroville, CA 95966
Phone (530) 534-7500

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Kim D Owens Individual Corporate DirectorBoard Member Apr 27, 2007
Benjamin H Flores Individual Corporate OfficerPresident & Ceo Apr 1, 2009 100%
J Angel Calderon Individual Corporate DirectorBoard Member Jan 31, 2012
Ernest Garcia Individual Corporate DirectorBoard Member Apr 1, 2015
Lorenzo Valdovinos Individual Corporate DirectorBoard Member Oct 23, 2018
Carlos Palacios Individual Corporate DirectorBoard Member May 1, 2017
Roberto B Gonzalez Individual Corporate DirectorBoard Member Jan 30, 2007
Teng Vang Individual Corporate DirectorBoard Member Jun 25, 2019
Horacio Paras Individual Corporate DirectorBoard Member Jun 1, 2013
Joyce Pope Individual Corporate DirectorBoard Member Feb 1, 2020
Vicki L Chissie Individual W-2 Managing EmployeePatient Accounts Manager Mar 19, 2012
Debbie D Porcayo Individual Corporate DirectorBoard Member Oct 27, 2009
Lilia Childs Individual Corporate DirectorBoard Member Mar 1, 2015
Wenceslao Vasquez Individual Corporate DirectorBoard Member Jan 28, 2004

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 6

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": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1831115070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX AD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959921396",
            "telephone_number": "530-751-3778",
            "fax_number": "530-751-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SUTTER ST",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913459",
            "telephone_number": "530-673-9420",
            "fax_number": "530-673-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT, CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "530-751-3778",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "230000280",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EWC:CDP:BCEDP",
            "identifier": "BCP70718F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXPANDED ACCESS TO PRIMARY CARE",
            "identifier": "EAP70718F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3883930",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70718F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ampla Health Yuba City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMPLA HEALTH YUBA CITY MEDICAL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.