Organization Active NPI

United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
National Provider Identifier
1972477404
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Practice address
3652 W Shields Ave
Fresno, CA 93722
Phone
(800) 492-4227
NPI assigned
Sep 29, 2025
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Mary Lou Lopez
Title
Director of Billing
Phone
(800) 492-4227

Specialties & licenses 1

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

Addresses

Primary practice location

3652 W Shields Ave
Fresno, CA 93722

Mailing address

3875 W Beechwood Ave
Fresno, CA 93711-0795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260602001401 CA Part A Provider - Federally Qualified Health Center (FQHC) 5991727802 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972477404. Details of each certification follow.

Federally qualified health center certification: CCN A11048

Legal name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 11, 2026
Last certification
Mar 11, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3652 W Shields Ave
Fresno, CA 93722

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
05D2335403United Health Centers of San Joaquin Valley-3652 W Shields Avenue, Fresno, CA 93722Certificate of waiverDec 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Orange Cove Family Health91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Joseph Amador Individual Corporate DirectorBoard Member Oct 1, 2024
Patrick Thomas Rea Individual W-2 Managing EmployeeCredentialing Manager Oct 3, 2022
Daniel T Parra Individual Corporate DirectorBoard Member Mar 1, 2017
Jesus Rafael Maldonado Hernandez Individual Corporate OfficerVP & Cfo Nov 2, 2015
Michael Graville Individual Corporate DirectorBoard Member Jan 1, 2023
Ofelia Garcia Individual Corporate DirectorBoard Member Mar 31, 2011
Sarah Guerra Individual Corporate DirectorBoard Member Jan 1, 2018
Edna L Avalos Individual Corporate DirectorBoard Member Jan 1, 2018
Nathan Williams Individual Corporate DirectorBoard Member Sep 1, 2018
Jose Gutierrez Individual Corporate DirectorBoard Member Aug 1, 2020
Nicole Thompson Individual Corporate DirectorBoard Member Jan 1, 2023
Stephanie Sherrell Individual Corporate DirectorBoard Member Aug 1, 2024
Justin W Preas Individual Corporate OfficerPresident & Ceo Apr 25, 2005

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
United Health Centers of the San Joaquin ValleyCorcoran, CA, CCN 751010 Federally qualified health center Operational/Managerial Control (100%) Feb 21, 2012
United Health Centers of the San Joaquin ValleyReedley, CA, CCN 751086 Federally qualified health center Operational/Managerial Control Jun 23, 2014
United Health Centers of the San Joaquin ValleyFresno, CA, CCN 751895 Federally qualified health center Operational/Managerial Control Apr 10, 2023
United Health Centers of the San Joaquin ValleyFresno, CA, CCN 751930 Federally qualified health center Operational/Managerial Control Dec 8, 2015
United Health Centers of the San Joaquin ValleySanger, CA, CCN 921076 Federally qualified health center Operational/Managerial Control Feb 28, 2018
United Health Centers of the San Joaquin ValleyLemoore, CA, CCN 921073 Federally qualified health center Operational/Managerial Control Apr 19, 2018
United Health Centers of the San Joaquin ValleyFowler, CA, CCN A01933 Federally qualified health center Operational/Managerial Control (100%) Sep 15, 2016

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1972477404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 W BEECHWOOD AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 W SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93722",
            "telephone_number": "800-492-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARY LOU",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "800-492-4227"
    },
    "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 Fresno, CA

Sources for this page

Verify at the official NPI Registry.