County of Ventura
Organization Active NPI Federally Qualified Health Center (FQHC) · Oxnard, CA
NPI 1861633703 · NPPES record last updated Jul 19, 2024
Key facts
- NPI
- 1861633703
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- H80CS00247-06-03 (CA)
- Legal business name
- COUNTY OF VENTURA
- Practice address
- 2240 E Gonzales Rd Ste 100
Oxnard, CA 93036-8212 - Phone
- (805) 981-5161
- Fax
- (805) 981-5160
- NPI assigned
- Mar 23, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- VENTURA COUNTY MEDICAL CENTER
Authorized official
- Name
- Theresa Cho, MD
- Title
- Director
- Phone
- (805) 677-5290
Owners & managing parties with NPI records 20
Owned or controlled facilities with NPI records 17
Other NPIs on the same Medicare enrollment 38
Other NPIs with the same Medicare PAC ID 20
Facilities with the same owner 17
Practitioners 341
-
Sohail Abdi-Moradi, M.D.
-
Levana Adato, LCSW
-
Afshin Ahoubim, M.D
-
Anne Akhimien, MD
-
Melissa Hansen Ambrosio, PA-C
-
Asad Amir, M.D.
-
Alejandro Andrade, M.D.
-
Lucy Maribel Andrade, LCSW
-
David Araujo, M.D.
-
Julianne Marie Awrey, M.D.
-
Michelle Beth Azimov, M.D.
-
Ravinder S Bajwa, MD
-
Nell Wheeler Baldwin, M.D.
-
Melissa Lee Barger, M.D.
-
Erin Barletta, MD
-
Linda Dianna Basquez, FNP
-
Mounir Belcadi, MD
-
Emily Suzanne Benson, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 051173
- Legal name
- COUNTY OF VENTURA
- Doing business as
- MAGNOLIA FAMILY MEDICAL GROUP
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 3, 2009
- Last certification
- Aug 3, 2009
- Ownership / control type
- Non-profit – corporation
- Organization structure
- Other · Non-profit
- Incorporated
- Aug 3, 2009 in CA
- Enrollment address
- 2240 E Gonzales Rd, Ste 100
Oxnard, CA 93036-8212
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Barry Zimmerman |
Corporate Director | Jun 2, 2021 | |
| Elizabeth Schmeeckle |
W-2 Managing Employee | Sep 1, 2022 | |
| Operational/Managerial Control | Sep 1, 2022 | ||
| County of Ventura |
5% Or Greater Direct Ownership Interest | Mar 8, 2013 | 100% |
| Operational/Managerial Control | Aug 18, 2010 | 100% |
All facility ownership & control disclosures 17
| Facility | Type | Role | Since |
|---|---|---|---|
| Ventura County Medical Center |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 1966 Aug 18, 2010 |
| Conejo Valley Family Medical Group FQHC |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jun 29, 1994 |
| Las Islas Family Medical Group North |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Fillmore Family Medical Group |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| John K Flynn Community Clinic |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Las Posas Family Medical Group |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Feb 19, 2014 Jan 1, 2013 |
| Sierra Vista Family Medical Clinic |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula Hospital Clinic |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Pediatric Diagnostic Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Santa Paula West |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Mar 8, 2013 |
| Moorpark Family Medical Group |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2008 |
| Mandalay Bay Womens & Childrens |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Santa Paula Medical Clinic |
Federally qualified health center | 5% Or Greater Indirect Ownership Interest (100%) | Jan 1, 2013 |
| West Ventura Medical Clinic |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Mar 8, 2013 Aug 18, 2010 |
| Las Islas Family Medical Group II |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 24, 2013 Aug 18, 2010 |
| Ventura County Healthcare for the Homeless Program |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 24, 2013 |
| Magnolia West |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000587 | CA | Part B Supplier - Clinic/Group Practice | 7911810171 |
Receives reassigned benefits from 748 practitioners 40 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ventura, CA; Fillmore, CA; Thousand Oaks, CA; Camarillo, CA; Oxnard, CA; Santa Paula, CA; Simi Valley, CA |
| O20090714000319 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 7911810171 | Practice locations: Oxnard, CA |
National Provider Directory
- Part of
- Penfield Mtu
Locations
800 S Victoria Ave
#4640
Ventura, CA 93009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | H80CS00247-06-03 | CA | Yes |
Addresses
Primary practice location
2240 E Gonzales Rd Ste 100
Oxnard, CA 93036-8212
Mailing address
800 S Victoria Ave # L4615
Ventura, CA 93009-0003
Phone (805) 677-5210
Other names
- Magnolia Family Medical Center
Other providers in Oxnard, CA
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- County of Ventura
- Sonia Moreno Morales Coursey
All providers in Oxnard, 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 Jul 19, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.