NPIMap

Organization Active NPI

The Childrens Clinic 'Serving Children and Their Families'

  • Community Health Clinic/Center
  • Long Beach, CA
National Provider Identifier
1851775795
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'
Practice address
1574 Linden Ave
Long Beach, CA 90813-2032
Phone
(562) 264-3101
Fax
(562) 216-6191
NPI assigned
Jul 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Jina L. Lawler, MSW
Title
Chief Operations Officer
Phone
(562) 264-3985

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X CA Primary
Federally Qualified Health Center (FQHC) 261QF0400X CA

Addresses

Primary practice location

1574 Linden Ave
Long Beach, CA 90813-2032

Mailing address

701 E 28TH St
Suite 200
Long Beach, CA 90806-2759
Phone (562) 264-3985

Other names 1

  • The Children's Clinic Family Health Center Roosevelt Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161219002834 CA Part A Provider - Federally Qualified Health Center (FQHC) 3870544919 Practice locations: Long Beach, CA

Federally qualified health center certification: CCN 751942

Legal name
THE CHILDREN'S CLINIC SERVING CHILDREN AND THEIR FAMILIES
Doing business as
THE CHILDREN'S CLINIC FAMILY HEALTH CENTER ROOSEVELT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 19, 2016
Last certification
Dec 19, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 16, 1939 in CA
Enrollment address
1574 Linden Ave
Long Beach, CA 90813-2032

Other NPIs with the same Medicare PAC ID 10

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

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
05D2102469Childrens Clinic1574 Linden Ave, Long Beach, CA 90813Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
The Children'S Clinic Serving Children and Their Families17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Cynthia a. Begazo Individual Corporate DirectorChief Human Resources Officer Dec 3, 2015
W-2 Managing EmployeeChief Human Resources Officer Dec 3, 2015
Operational/Managerial ControlChief Human Resources Officer Dec 3, 2015
Ricardo Ornelas Individual Corporate DirectorDirector of Finance Dec 3, 2015
Operational/Managerial ControlDirector of Finance Dec 3, 2015
Sandra Molina Individual Corporate DirectorDirector of Billing & Patient SVCS Dec 3, 2015
W-2 Managing EmployeeDirector of Billing & Patient SVCS Dec 3, 2015
Operational/Managerial ControlDirector of Billing/Patient Service Dec 3, 2015
Andrew Horvath Individual Corporate DirectorChief Information Officer Dec 3, 2015
Operational/Managerial ControlChief Information Officer Dec 3, 2015
Maria Chandler Individual Corporate DirectorChief Medical Officer Dec 3, 2015 100%
W-2 Managing EmployeeChief Medical Officer Dec 3, 2015
Operational/Managerial ControlChief Medical Officer Dec 3, 2015
Jina Lawler Individual Corporate DirectorChief Operations Officer Jun 1, 2008 100%
W-2 Managing EmployeeChief Operations Officer Jun 1, 2008
Operational/Managerial ControlChief Operations Officer Jun 1, 2008
Elisa Nicholas Individual Corporate DirectorChief Executive Officer Jul 1, 1988 100%
W-2 Managing EmployeeChief Executive Officer Jul 1, 1988 100%
Operational/Managerial ControlChief Executive Officer Jul 1, 1988 100%

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1851775795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-264-3985",
            "fax_number": "562-216-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 LINDEN AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908132032",
            "telephone_number": "562-264-3101",
            "fax_number": "562-216-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "LAWLER",
        "authorized_official_first_name": "JINA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "562-264-3985",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Children's Clinic Family Health Center Roosevelt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Children's Clinic Family Health Center Roosevelt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.