NPIMap

Organization Active NPI

Valle del Sol, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
National Provider Identifier
1922527928
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLE DEL SOL, INC.
Practice address
502 N 27TH Ave
Phoenix, AZ 85009-4420
Phone
(602) 258-6797
NPI assigned
Sep 12, 2017
Last updated
Jun 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Rebecca Razo
Title
Director of Contracts & Licensing
Phone
(602) 258-6797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

502 N 27TH Ave
Phoenix, AZ 85009-4420

Mailing address

3877 N 7TH St Ste 400
Phoenix, AZ 85014-5061
Phone (602) 258-6797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050516000299 AZ Part B Supplier - Clinic/Group Practice 8628019148 Receives reassigned benefits from 76 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Mesa, AZ
O20170922000797 AZ Part A Provider - Federally Qualified Health Center (FQHC) 8628019148 Practice locations: Phoenix, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922527928. Details of each certification follow.

Federally qualified health center certification: CCN 031954

Legal name
VALLE DEL SOL INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 8, 2017
Last certification
Aug 8, 2017
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Dec 9, 1970 in AZ
Enrollment address
502 N 27TH Ave
Phoenix, AZ 85009-4420

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory
Tax ID family
Valle del Sol17 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

Locations

3877 N 7th St
Ste 400
Phoenix, AZ 85014
Phone (602) 257-8118

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
June Campbell Individual Corporate DirectorBoard Member Jul 24, 2017
Carmen Heredia Individual Corporate OfficerCeo Dec 1, 2019
W-2 Managing EmployeeCeo Dec 1, 2019
Manuel Calero Individual Corporate DirectorBoard Member Jul 24, 2017
Joseph Losada Individual Corporate OfficerCfo Apr 6, 2020
Rick Carter Individual Corporate Director Jan 1, 2021
Desiree S Cogley Individual Corporate DirectorDirector of Human Services Jul 24, 2017
Florentino Gabriel Licon Individual Corporate DirectorBoard Member Jul 24, 2017
Helena Gudger Individual Corporate DirectorBoard Member Jul 24, 2017
Rebecca Razo Individual W-2 Managing EmployeeContracts Director May 7, 2018
Virginia Valenzuela Individual Corporate DirectorBoard Member Jan 1, 2022
Andrea Moreno Individual Corporate DirectorBoard Member Jul 24, 2017
Diana Ixchel del Castillo Medina Individual Corporate DirectorBoard Member Jul 24, 2017
Linda McPhaul Individual Corporate DirectorBoard Member Jul 24, 2017
Valle del Sol Inc Organization, Phoenix, AZ Corporation Other Jul 24, 2017
Arthur Ruiz Individual Corporate DirectorBoard Member Jul 24, 2017

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valle del Sol IncPhoenix, AZ, CCN 031921 Federally qualified health center Operational/Managerial Control Sep 4, 2018
Valle del Sol IncPhoenix, AZ, CCN 031922 Federally qualified health center Operational/Managerial Control Feb 16, 2015
Valle del Sol IncMesa, AZ, CCN 031972 Federally qualified health center Other May 1, 2018
Valle del Sol IncPhoenix, AZ, CCN 031986 Federally qualified health center Operational/Managerial Control Nov 1, 2019
Valle del Sol IncMesa, AZ, CCN 031006 Federally qualified health center Operational/Managerial Control Dec 9, 1970
Valle del Sol IncPhoenix, AZ, CCN 031063 Federally qualified health center Operational/Managerial Control Aug 5, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1922527928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 N 7TH ST STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145061",
            "telephone_number": "602-258-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850094420",
            "telephone_number": "602-258-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLE DEL SOL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "RAZO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTS & LICENSING",
        "authorized_official_telephone_number": "602-258-6797"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.