NPIMap

Organization Active NPI

United Health Centers of the San Joaquin Valley

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
National Provider Identifier
1982079620
Registry record updated Apr 9, 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
4615 N 1St St
Fresno, CA 93726-0904
Phone
(800) 492-4227
Fax
(559) 646-6614
NPI assigned
Dec 7, 2015
Last updated
Apr 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4615 N 1St St
Fresno, CA 93726-0904

Mailing address

3875 W Beechwood Ave
Fresno, CA 93711-0795
Phone (800) 492-4227

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161116001053 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 1982079620. Details of each certification follow.

Federally qualified health center certification: CCN 751930

Legal name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 15, 2016
Last certification
Sep 15, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 15, 1971 in CA
Enrollment address
4615 N 1St St
Fresno, CA 93726-0904

National Provider Directory

National Provider Directory
Tax ID family
United Health Centers S91 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Daniel T Parra Individual Corporate DirectorParliamentarian Mar 1, 2017
Jesus Rafael Maldonado Hernandez Individual Corporate OfficerCfo Nov 20, 2015
Michael Graville Individual Corporate DirectorBoard Member Jan 1, 2023
United Health Centers of the San Joaquin Valley Organization, Fowler, CA Corporation, Non-profit Operational/Managerial Control Dec 8, 2015
Ofelia Garcia Individual Corporate DirectorBoard Director Mar 31, 2011
Sarah Guerra Individual Corporate DirectorBoard Vice Chair Jan 1, 2018
Edna L Avalos Individual Corporate DirectorBoard Member Jan 1, 2018
Nathan Williams Individual Corporate DirectorBoard Treasurer Sep 21, 2018
John Shantz Individual Corporate DirectorBoard Chair Apr 1, 2015
Navjot Singh Individual W-2 Managing EmployeeDirector of Managed Care Jun 5, 2017
Jose Gutierrez Individual Corporate DirectorBoard Member Aug 1, 2020
Raul Venegas Individual Corporate OfficerCio Sep 3, 2006
Nicole Thompson Individual Corporate DirectorBoard Member Nov 1, 2020
Justin W Preas Individual Corporate OfficerDeputy Ceo Apr 25, 2005

All facility ownership & control disclosures 6

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 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

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1982079620",
    "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",
            "telephone_number": "800-492-4227",
            "fax_number": "559-646-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260904",
            "telephone_number": "800-492-4227",
            "fax_number": "559-646-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "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": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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.