H Street Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

550000837 Issued in CA

Legal business name

H STREET CLINIC

Practice address

1329 N H St
San Bernardino, CA 92405-5039

Phone

(909) 381-0803

Fax

(909) 381-0823

NPI assigned

Jan 7, 2009

Last updated

Dec 15, 2020By 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

Eleanor Perez

Title

Coo

Phone

(909) 381-0803

Specialties & licenses 2

Addresses

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 1841437241. Details of each certification follow.

• CCN 921153 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 921153

Legal name

H STREET CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 3, 2019

Last certification

May 3, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Dec 18, 2006 in CA

Enrollment address

1329 N H St
San Bernardino, CA 92405-5039

Other NPIs with the same Medicare PAC ID 4

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

• H Street Clinic

  dba Central Neighborhood Health Foundation - Norwalk

  • Community Health Clinic/Center
  • Norwalk, CA
  • NPI 1073259305

  3870693781

  Same PAC ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1447872577

  3870693781

  Same PAC ID
• H Street Clinic

  dba H Street Clinic Coachella

  • Federally Qualified Health Center (FQHC)
  • Coachella, CA
  • NPI 1528653482

  3870693781

  Same PAC ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Inglewood

  • Federally Qualified Health Center (FQHC)
  • Inglewood, CA
  • NPI 1548610322

  3870693781

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

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

• H Street Clinic

  dba Central Neighborhood Health Foundation - Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1447872577

  O20090522000321

  Same enrollment
• H Street Clinic

  dba Central Neighborhood Health Foundation Atlantic Clinic

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1518798040

  O20090522000321

  Same enrollment
• H Street Clinic

  dba Central Neighborhood Health Foundation - Inglewood

  • Federally Qualified Health Center (FQHC)
  • Inglewood, CA
  • NPI 1548610322

  O20090522000321

  Same enrollment

Tax ID family

H Street Clinic14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

• Central Neighborhood Health Foundat

  dba Central Neighborhood Health Foundation

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1699248674
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Norwalk

  • Community Health Clinic/Center
  • Norwalk, CA
  • NPI 1073259305
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Lucas Clinic

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1215706841
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #2

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1265136329
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #3

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1285338475
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Mobile Care Clinic #1

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1306540463
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Upland

  • Primary Care Clinic/Center
  • Upland, CA
  • NPI 1407492267
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1447872577
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Wilshire

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1457116709
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation Atlantic Clinic

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1518798040
  NPD tax ID
• H Street Clinic

  dba H Street Clinic Coachella

  • Federally Qualified Health Center (FQHC)
  • Coachella, CA
  • NPI 1528653482
  NPD tax ID
• H Street Clinic

  dba Central Neighborhood Health Foundation - Inglewood

  • Federally Qualified Health Center (FQHC)
  • Inglewood, CA
  • NPI 1548610322
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Central Neighborhood Health Foundation

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1639336803

  Member Of

  NPD member

Locations

All disclosed owners & managing parties 8

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

Owners & managing parties with NPI records 1

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

• Central Neighborhood Health Foundation

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1639336803

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

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

• H Street Clinic

  dba Central Neighborhood Health Foundation - Riverside

  • Federally Qualified Health Center (FQHC)
  • Riverside, CA
  • NPI 1447872577

  Central Neighborhood Health Foundation

  CMS ownership
• H Street Clinic

  dba H Street Clinic Coachella

  • Federally Qualified Health Center (FQHC)
  • Coachella, CA
  • NPI 1528653482

  Central Neighborhood Health Foundation

  CMS ownership
• H Street Clinic

  dba Central Neighborhood Health Foundation - Inglewood

  • Federally Qualified Health Center (FQHC)
  • Inglewood, CA
  • NPI 1548610322

  Central Neighborhood Health Foundation

  CMS ownership

Practitioners 16

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.

• Carly Janell Miller, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1790351674

  CA

  Medicare reassignment Care Compare group NPD (past)
• Pamala Estrada-Molina, ACSW, MSW

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1780341388
  Medicare reassignment Care Compare group
• Bessy Jasmin Ortega, LCSW

  • Clinical Social Worker
  • Lynwood, CA
  • NPI 1760718274
  Medicare reassignment Care Compare group
• Marlena Arredondo

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1235027426
  Medicare reassignment
• Lorena Asher, FNP

  • Nurse Practitioner
  • Fountain Vallet, CA
  • NPI 1538110358
  Medicare reassignment
• Brian Earl Bristol, ANP-C

  • Nurse Practitioner
  • Cerritos, CA
  • NPI 1265777981
  Medicare reassignment
• Moses Choi, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1144872268
  Medicare reassignment
• Leo Ernie Manangan Domingo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Beach, CA
  • NPI 1073281754
  Medicare reassignment
• Claudia Ferrer, PA

  • Physician Assistant
  • Montebello, CA
  • NPI 1457859340
  Medicare reassignment
• Vernica Neche Foots

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynwood, CA
  • NPI 1184250144
  Medicare reassignment
• Chelsea Grenfell

  • Social Worker
  • Upland, CA
  • NPI 1154849602
  Medicare reassignment
• Michael Saksam Sar, LCSW

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1043402258
  Medicare reassignment

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1841437241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 N H ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924055039",
            "telephone_number": "909-381-0803",
            "fax_number": "909-381-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 N H ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924055039",
            "telephone_number": "909-381-0803",
            "fax_number": "909-381-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H STREET CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "909-381-0803"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "550000837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Gwyn, CADC I
• Gypsy Testing, LLC
• H Street Clinic (Central Neighborhood Health Foundation - Mobile Care Clinic #2)
• H Street Clinic (Central Neighborhood Health Foundation - Mobile Care Clinic #3)
• H Street Clinic (Central Neighborhood Health Foundation - Mobile Care Clinic #1)
• H Street Medical Associates, Inc
• H.E.L.P. Housing (Housing Every Living Person)
• Eunice Taehyun Ha, LMFT
• Priscilla Ha
• Hacienda Heights Healthcare & Wellness Centre, LP

• Primary Care Clinic/Center in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.