NPIMap

Organization Active NPI

Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
National Provider Identifier
1891778114
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
040000045 Issued in CA
Legal business name
CAMARENA HEALTH
Practice address
344 E 6TH Street
Madera, CA 93638-3631
Phone
(559) 664-4000
Fax
(559) 675-5625
NPI assigned
Nov 21, 2005
Last updated
Mar 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Mr. Paulo A Soares
Title
Chief Executive Officer
Phone
(559) 664-4000

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
General Practice Dentistry 1223G0001X NU
Dental Assistant 126800000X NU
Diabetes Educator Registered Nurse 163WD0400X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Federally Qualified Health Center (FQHC) 261QF0400X 040000045 CA Primary
Physician Assistant 363A00000X NU
Family Nurse Practitioner 363LF0000X NU
Women's Health Nurse Practitioner 363LW0102X NU

Addresses

Primary practice location

344 E 6TH Street
Madera, CA 93638-3631

Mailing address

PO Box 299
Madera, CA 93639-0299
Phone (559) 664-4000

Other identifiers 4

IdentifierTypeStateIssuer
EAP70046FOtherCAMEDICAL
HAP70046FOtherCAMEDICAL
FHC70046FOtherCAMEDICAL
BCP70046FOtherCAMEDICAL

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040318000523 CA Part B Supplier - Clinic/Group Practice 4880584317 Receives reassigned benefits from 178 practitioners
16 other NPIs on this enrollment
Practice locations: Oakhurst, CA; Madera, CA; Fresno, CA; Coarsegold, CA; Chowchilla, CA
O20100824000978 CA Part A Provider - Federally Qualified Health Center (FQHC) 4880584317 Practice locations: Madera, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891778114. Details of each certification follow.

Federally qualified health center certification: CCN 051824

Legal name
CAMARENA HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 21, 1978 in CA
Enrollment address
344E 6TH St
Madera, CA 93638-3631

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Other NPIs on the same Medicare enrollment 16

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

View all 16

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
05D0704826Camarena Health344 E 6TH St, Madera, CA 93638Provider-performed microscopySep 8, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Patty Thompson Individual Corporate DirectorBoard Member Dec 1, 2023
Martha Cardona Individual Corporate DirectorBoard Member Vice President May 23, 2018
Edgar Jimenez Individual Corporate DirectorBoard Member Feb 1, 2011
Paulo a Soares Individual Corporate OfficerChief Executive Officer Feb 1, 2011 50%
Monic Asenjo-Wilhite Individual Corporate DirectorBoard Member President Feb 1, 2011
Seann Garcia Individual Corporate DirectorBoard Member Feb 1, 2011
Virginia M Lane-Pacheco Individual Corporate DirectorBoard Treasurer Jan 1, 2025
Oracio M Rodriguez Individual Corporate DirectorBoard Member Jan 1, 2025
Abimael Vargas Individual Corporate DirectorBoard Member May 25, 2011
Christine N Howland Individual Corporate OfficerChief Operations Officer Apr 11, 2011 25%
W-2 Managing EmployeeChief Operations Officier Apr 11, 2011 25%
Raquel Rodarte Individual Corporate DirectorBoard Member Secretary Jan 1, 2015
Bruce Alamedia Individual Corporate DirectorBoard Treasurer Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 187

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.

View all 187

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1891778114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 299",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936390299",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 6TH STREET",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMARENA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "SOARES",
        "authorized_official_first_name": "PAULO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "559-664-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "040000045",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "EAP70046F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "HAP70046F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC70046F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "BCP70046F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.