Camarena Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Fresno, CA
NPI 1841815347 · NPPES record last updated Jun 10, 2020
Key facts
- NPI
- 1841815347
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CAMARENA HEALTH
- Practice address
- 7202 N Millbrook Ave Ste 202
Fresno, CA 93720-3341 - Phone
- (559) 664-4000
- Fax
- (559) 675-5625
- NPI assigned
- Jun 10, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- CAMARENA HEALTH
Authorized official
- Name
- Mrs. Luzvinda Gabriela Martinez
- Title
- Billing Manager
- Phone
- (559) 664-4000
Other NPIs on the same Medicare enrollment 16
Other NPIs with the same Medicare PAC ID 23
Corporate family (same tax ID) 22
Practitioners 86
-
Naeem M. Akhtar, MD
-
Mohammad Ashraf, MD
-
Manjot Kaur Batth, O.D.
-
Kenneth Bernstein, M.D.
-
Asha Blades, DPM
-
Angelina Bravo, FNP-C
-
Erika Cano, FNP-C
-
Gabriel Carpio-Bracho, M.D.
-
Stephanie Castillo, FNP
-
Frank Paul Chimienti, P.A.
-
Jack Douglas Clark, M.D.
-
Ilsook Park Dahlin, FNP
-
David J Drake, MD
-
Daniel Duron, NP
-
Nathan Robert Elledge, D.O.
-
Christopher Frank Fasulo, PA-C
-
Monica F Garcia, OD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2181822 | Camarena Helath-Millbrook Health Center | Certificate of waiver | Apr 12, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 921897
- Legal name
- CAMARENA HEALTH
- Doing business as
- CAMARENA HEALTH MILLBROOK HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 6, 2020
- Last certification
- Aug 6, 2020
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 21, 1978 in CA
- Enrollment address
- 7202 N Millbrook Ave
Ste 202
Fresno, CA 93720-3341
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Patty Thompson |
Corporate Director |
Dec 1, 2023 | |
| Martha Cardona |
Corporate Director |
May 23, 2018 | |
| Edgar Jimenez |
Corporate Director |
Jul 16, 2013 | |
| Paulo a Soares |
Corporate Officer |
Feb 1, 2011 | |
| Monic Asenjo-Wilhite |
Corporate Director |
Jan 24, 2001 | |
| Seann Garcia |
Corporate Director |
Nov 16, 2011 | |
| Virginia M Lane-Pacheco |
Corporate Director |
Jan 1, 2025 | |
| Oracio M Rodriguez |
Corporate Director |
Jan 1, 2025 | |
| Abimael Vargas |
Corporate Director |
May 25, 2011 | |
| Christine N Howland |
Corporate Officer |
Apr 11, 2011 | 25% |
| W-2 Managing Employee |
Apr 11, 2011 | 25% | |
| Raquel Rodarte |
Corporate Director |
Jan 1, 2015 | |
| Bruce Alamedia |
Corporate Director |
Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040318000523 | CA | Part B Supplier - Clinic/Group Practice | 4880584317 |
Receives reassigned benefits from 178 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA |
| O20200915001645 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 4880584317 | Practice locations: Fresno, CA |
National Provider Directory
- Tax ID family
- Darin M Camarena HLTH C
- Part of
- Darin M Camarena HLTH C
Locations
300 Prosperity Blvd
Chowchilla, CA 93610
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
7202 N Millbrook Ave Ste 202
Fresno, CA 93720-3341
Mailing address
PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000
Other names
- Millbrook Health Center
Other providers in Fresno, CA
- Heidi Camacho
- Jessica Melinda Camacho
- Melinda Camacho
- Rosa Yolanda Camacho
- Camarena Health
- Guadalupe Camarena
- Jackie Camarena
- Rafael Camarena
- Nayle Camarillo Gutierrez
- Jessica Camarillo
All providers in Fresno, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.