Active NPI
Ole Health
- Federally Qualified Health Center (FQHC)
- Napa, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- OLE HEALTH
- Practice address
- 300 Hartle CT.
Napa, CA 94559-4078 - Phone
- (707) 254-1774
- Fax
- (707) 251-2988
- NPI assigned
- Oct 22, 2010
- Last updated
- Feb 6, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Alicia Hardy
- Title
- Chief Executive Officer
- Phone
- (707) 254-1774
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | CA | Primary |
Addresses
Primary practice location
300 Hartle CT.
Napa, CA 94559-4078
Mailing address
1141 Pear Tree LN Ste 100
Napa, CA 94558-6485
Phone (707) 254-1770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC11719F | Medicaid | CA |
Other names 1
- Community Health Clinic Ole
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040427001735 | CA | Part B Supplier - Clinic/Group Practice | 7315934767 |
Receives reassigned benefits from 134 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Napa, CA; Saint Helena, CA; Fairfield, CA; Calistoga, CA; American Canyon, CA |
| O20140219000069 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 7315934767 | Practice locations: Napa, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1902106198. Details of each certification follow.
Federally qualified health center certification: CCN 751032
- Legal name
- OLE HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 23, 2014
- Last certification
- Jan 23, 2014
- Ownership / control type
- Non-profit – church related
- Organization structure
- Corporation
- Incorporated
- Oct 4, 1972 in CA
- Enrollment address
- 300 Hartle CT
Napa, CA 94559-4078
Other NPIs with the same Medicare PAC ID 12
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Davis, CA
- NPI 1558366823
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- Woodland, CA
- NPI 1558469064
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1710087515
7315934767
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1881330579
7315934767
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- American Canyon, CA
- NPI 1508573379
O20040427001735
National Provider Directory
National Provider Directory- Tax ID family
- Ole Health
Other organizations with this tax ID 21
Organizations that report the same tax identification number in the National Provider Directory.
-
dba CommuniCare OLE
- Adolescent and Children Mental Health Clinic/Center
- Woodland, CA
- NPI 1073006607
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1144687955
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1245043165
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1275257826
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
-
dba CommuniCare Family Wellness Center - Unity Building
- Community/Behavioral Health Agency
- Woodland, CA
- NPI 1366091191
-
- Federally Qualified Health Center (FQHC)
- Napa, CA
- NPI 1447687330
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1497130280
-
- Federally Qualified Health Center (FQHC)
- American Canyon, CA
- NPI 1508573379
Locations
470 Chadbourne Rd
Ste A
Fairfield, CA 94534
Phone (707) 419-8989
Ownership & related parties
All disclosed owners & managing parties 19
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Richmond | Corporate Director | Feb 4, 2022 | |
| Madeline Hernandez | Corporate Director | Apr 23, 2019 | |
| Dawnielle Thornburgh | Corporate Director | Oct 1, 2013 | |
| Deborah Goodin | Corporate Director | Feb 4, 2022 | |
| Joseph Manuel Carrillo | Corporate Director | Feb 4, 2022 | |
| Ebon Richard Jones | Corporate Director | Oct 1, 2013 | |
| Maira Ayala | Corporate Director | Dec 3, 2013 | |
| Exa Johanna Moore | Corporate Director | Oct 1, 2013 | |
| Brandy Lane | Corporate Director | Feb 4, 2022 | |
| Beatrice Labastida | Corporate Director | Dec 22, 2015 | |
| Cynthia Macias | Corporate Director | Feb 4, 2022 | |
| Arthur Roosa | Corporate Director | Apr 23, 2019 | |
| Patricia McFarland | Corporate Director | Dec 6, 2016 | |
| Monin Martin | Corporate Director | Feb 7, 2022 | |
| Cephas Mugerwa | Corporate Director | Feb 4, 2022 | |
| Bryan Nazario | Corporate Director | Feb 4, 2022 | |
| Lori Wilson | Corporate Director | Feb 4, 2022 | |
| Anna Roth | Corporate Director | Feb 4, 2022 | |
| Alicia F Hardy | Corporate Officer | Jan 8, 2018 | |
| W-2 Managing Employee | Jan 8, 2018 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ole Health | Federally qualified health center | Operational/Managerial Control (100%) | Sep 14, 2018 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- Fairfield, CA
- NPI 1316429558
Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 23
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.
-
- Clinical Social Worker
- Napa, CA
- NPI 1194908475
-
- Psychiatry Physician
- Napa, CA
- NPI 1063806743
-
- Marriage & Family Therapist
- West Sacramento, CA
- NPI 1497321020
-
- Pediatrics Physician
- Orinda, CA
- NPI 1538521224
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1215236443
-
- Pediatrics Physician
- Napa, CA
- NPI 1104183904
-
- Family Medicine Physician
- Fairfield, CA
- NPI 1144809575
-
- Physician Assistant
- Napa, CA
- NPI 1730467051
-
- Optometrist
- Davis, CA
- NPI 1245682178
-
- Clinical Social Worker
- Napa, CA
- NPI 1710283882
-
- Family Medicine Physician
- Sacramento, CA
- NPI 1194303966
-
- Family Nurse Practitioner
- Fairfield, CA
- NPI 1558777292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580947200000",
"number": "1902106198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 PEAR TREE LN STE 100",
"city": "NAPA",
"state": "CA",
"postal_code": "945586485",
"telephone_number": "707-254-1770",
"fax_number": "707-254-1779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HARTLE CT.",
"city": "NAPA",
"state": "CA",
"postal_code": "945594078",
"telephone_number": "707-254-1774",
"fax_number": "707-251-2988"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OLE HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-22",
"last_updated": "2020-02-06",
"certification_date": "2020-02-06",
"status": "A",
"authorized_official_last_name": "HARDY",
"authorized_official_first_name": "ALICIA",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "707-254-1774",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC11719F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Community Health Clinic Ole",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Community Health Clinic Ole",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.