Active NPI
Family Healthcare Network
- Federally Qualified Health Center (FQHC)
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- FAMILY HEALTHCARE NETWORK
- Practice address
- 1344 W Clinton Ave
Fresno, CA 93705-3805 - Phone
- (559) 737-4700
- Fax
- (559) 741-8414
- NPI assigned
- Apr 5, 2022
- Last updated
- Feb 28, 2024
- 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
- Kerry L Hydash
- Title
- President & Ceo
- Phone
- (559) 737-4700
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary | ||
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
1344 W Clinton Ave
Fresno, CA 93705-3805
Mailing address
305 E Center Ave
Visalia, CA 93291-6331
Phone (559) 737-4700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A01183 | Medicaid | CA | |
| A0-1183 | Other | CA | MEDICARE ID - TYPE UNSPECIFIED |
| ZZZ19552Z | Other | CA | MEDICARE ID - TYPE UNSPECIFIED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040123000681 | CA | Part B Supplier - Clinic/Group Practice | 6305756339 |
Receives reassigned benefits from 429 practitioners 35 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Reedley, CA; Ivanhoe, CA; Selma, CA; Springville, CA; Squaw Valley, CA; Strathmore, CA; Terra Bella, CA; Three Rivers, CA… |
| O20230817003152 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 6305756339 | Practice locations: Fresno, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1902547789. Details of each certification follow.
Federally qualified health center certification: CCN A01183
- Legal name
- FAMILY HEALTHCARE NETWORK
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 31, 2023
- Last certification
- Jul 31, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Jun 29, 1978 in CA
- Enrollment address
- 1344 W Clinton Ave
Fresno, CA 93705-3805
Other NPIs on the same Medicare enrollment 35
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- Pixley, CA
- NPI 1033661558
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Porterville, CA
- NPI 1053875484
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1063283158
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Tulare, CA
- NPI 1073997201
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Porterville, CA
- NPI 1083611156
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Fresno, CA
- NPI 1114407244
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Woodlake, CA
- NPI 1164517744
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Farmersville, CA
- NPI 1174175012
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Fresno, CA
- NPI 1225546575
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Fresno, CA
- NPI 1295478212
O20040123000681
-
- Federally Qualified Health Center (FQHC)
- Farmersville, CA
- NPI 1326317819
O20040123000681
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Kerry Hydash | Corporate Officer | Apr 23, 2013 | 100% |
| Corporate Director | Apr 23, 2013 | 100% | |
| W-2 Managing Employee | Apr 23, 2013 | 100% | |
| Emzy Cope | Corporate Director | Mar 18, 2006 | |
| Chad Vawter | Corporate Officer | Apr 23, 2013 | |
| Michael Botello | Corporate Director | Mar 18, 2006 | |
| Olivia Gamboa | Corporate Director | Feb 15, 2002 | |
| Teresa de la Rosa | Corporate Director | Jul 1, 2009 | |
| John Zapalac | Corporate Officer | Nov 26, 2007 | |
| Minnetta Costa | Corporate Director | Nov 16, 2011 | |
| Maria Gonzalez | Corporate Director | Mar 15, 1988 | |
| Sandra Miller | Corporate Officer | Oct 1, 2014 |
All facility ownership & control disclosures 15
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 29, 2019 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jun 29, 1978 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 7, 2019 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 29, 2019 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Apr 20, 2020 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 23, 2019 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 30, 2019 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 9, 2019 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Sep 16, 2019 |
| Family Healthcare Network | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Apr 1, 2013 Mar 1, 2024 |
| Family Healthcare Network | Federally qualified health center | Operational/Managerial Control (100%) | Jan 30, 2024 |
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Medical Physician Assistant
- Fresno, CA
- NPI 1922717214
-
- Physician Assistant
- San Francisco, CA
- NPI 1518637909
-
- Family Nurse Practitioner
- Fresno, CA
- NPI 1871595215
-
- Nurse Practitioner
- Fresno, CA
- NPI 1770821464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709078400000",
"number": "1902547789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 E CENTER AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932916331",
"telephone_number": "559-737-4700",
"fax_number": "559-741-8414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1344 W CLINTON AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937053805",
"telephone_number": "559-737-4700",
"fax_number": "559-741-8414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTHCARE NETWORK",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-05",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A",
"authorized_official_last_name": "HYDASH",
"authorized_official_first_name": "KERRY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "559-737-4700"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A01183",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID - TYPE UNSPECIFIED",
"identifier": "A0-1183",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID - TYPE UNSPECIFIED",
"identifier": "ZZZ19552Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
- Family Healthcare Network
- Family Healthcare Network
- Family Healthcare Network
- Family Healthcare Network
- Family Healthcare Network
- Family Is Why LLC
- Family Physicians Laboratories,Inc.
- Family Planning Associates Medical Group Inc (FPA Women's Health)
- Family Planning Associates Medical Group Inc (FPA Women's Health)
- Family Wellness Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.