Fallbrook Family Health Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A12819 Issued in CA

Legal business name

FALLBROOK FAMILY HEALTH CLINIC, INC.

Practice address

577 E Elder St Ste F
Fallbrook, CA 92028-3079

Phone

(760) 451-8815

Fax

(760) 451-8798

NPI assigned

May 5, 2014

Organization subpart

No

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

Authorized official

Name

Theresa R Sheridan, D.O.

Title

Osteopathic Physician

Phone

(760) 451-8815

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1952711517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 E ELDER ST STE F",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283079",
            "telephone_number": "760-451-8815",
            "fax_number": "760-451-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 E ELDER ST STE F",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283079",
            "telephone_number": "760-451-8815",
            "fax_number": "760-451-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLBROOK FAMILY HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OSTEOPATHIC PHYSICIAN",
        "authorized_official_telephone_number": "760-451-8815",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE ID NUMBER",
            "identifier": "20A12819",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eduardo Estrada, PPS
• Jennifer Evans, PPS
• Lidia Elizabeth Everett, MD
• Fairy Dog Mother
• Fallbrook Diagnostics
• Fallbrook Healthcare Center Operating Company, LLC
• Fallbrook Healthcare Foundation
• Fallbrook Healthcare Partners
• Fallbrook Hearty Smiles
• Fallbrook Home Care Services, LLC

• Family Medicine Physician in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.