County of Ventura

Organization Active NPI Federally Qualified Health Center (FQHC) · Camarillo, CA

NPI 1982846366 · NPPES record last updated Jul 19, 2024

Key facts

NPI
1982846366
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
H80CS00247-06-03 (CA)
Legal business name
COUNTY OF VENTURA
Practice address
3801 Las Posas Rd Ste 214
Camarillo, CA 93010-1426
Phone
(805) 437-0900
Fax
(805) 987-2878
NPI assigned
Mar 31, 2009
Organization subpart
Yes
Parent organization (as reported)
VENTURA COUNTY MEDICAL CENTER

Authorized official

Name
Theresa Cho, MD
Title
Director
Phone
(805) 677-5290

Owners & managing parties with NPI records 22

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

Owned or controlled facilities with NPI records 17

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

Other NPIs with the same Medicare PAC ID 20

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

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Facilities with the same owner 17

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

Practitioners 340

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 340

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Federally qualified health center certification: CCN 051189

Legal name
COUNTY OF VENTURA
Doing business as
LAS POSAS FAMILY MEDICAL GROUP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2009
Last certification
Aug 3, 2009
Ownership / control type
Non-profit – corporation
Organization structure
Other · Proprietary
Enrollment address
3801 Las Posas Rd 214
Camarillo, CA 93010-1426

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Theresa Lynn Cho
Individual
Corporate Director
Director of Healthcare Agency
May 1, 2024
W-2 Managing Employee
Director of Healthcare Agency
May 1, 2024
John Fankhauser
Individual
Corporate Officer
Ceo
May 1, 2024
Tracy Champan
Individual
Corporate Director
Director, Med Staff Admin
Jun 25, 2024
W-2 Managing Employee
Director, Med Staff Admin
Jun 25, 2024
County of Ventura
Organization · Camarillo, CA
5% Or Greater Direct Ownership Interest Feb 19, 2014 100%
Operational/Managerial Control Jan 1, 2013

All facility ownership & control disclosures 17

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

FacilityTypeRoleSince
Ventura County Medical Center
Ventura, CA · CCN 050159
Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 1, 1966
Aug 18, 2010
Magnolia Family Medical Group
Oxnard, CA · CCN 051173
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Mar 8, 2013
Aug 18, 2010
Conejo Valley Family Medical Group FQHC
Thousand Oaks, CA · CCN 051179
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 29, 1994
Las Islas Family Medical Group North
Oxnard, CA · CCN 051183
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
Fillmore Family Medical Group
Fillmore, CA · CCN 551048
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
John K Flynn Community Clinic
Oxnard, CA · CCN 051182
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
Sierra Vista Family Medical Clinic
Simi Valley, CA · CCN 051176
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Mar 8, 2013
Aug 18, 2010
Santa Paula Hospital Clinic
Santa Paula, CA · CCN 051180
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
Pediatric Diagnostic Center
Ventura, CA · CCN 051186
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Mar 8, 2013
Aug 18, 2010
Santa Paula West
Santa Paula, CA · CCN 051178
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 8, 2013
Moorpark Family Medical Group
Moorpark, CA · CCN 051188
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2008
Mandalay Bay Womens & Childrens
Oxnard, CA · CCN 051174
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
Santa Paula Medical Clinic
Santa Paula, CA · CCN 051181
Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jan 1, 2013
West Ventura Medical Clinic
Ventura, CA · CCN 051177
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Mar 8, 2013
Aug 18, 2010
Las Islas Family Medical Group II
Oxnard, CA · CCN 551063
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)
Jan 24, 2013
Aug 18, 2010
Ventura County Healthcare for the Homeless Program
Ventura, CA · CCN 551141
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 24, 2013
Magnolia West
Oxnard, CA · CCN 751047
Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2013

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090717000575 CA Part a Provider - Federally Qualified Health Center (FQHC) 7911810171 Practice locations: Camarillo, CA

National Provider Directory

Tax ID family
Penfield Mtu (84 organizations share this tax ID)
Part of
Penfield Mtu

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X H80CS00247-06-03 CA Yes

Addresses

Primary practice location

3801 Las Posas Rd Ste 214
Camarillo, CA 93010-1426

Mailing address

800 S Victoria Ave # L4615
Ventura, CA 93009-0001
Phone (805) 677-5210

Other names

  • Las Posas Family Medical Group FQHC Doing business as

Other providers in Camarillo, CA

All providers in Camarillo, CA · Federally Qualified Health Center (FQHC) in California

Sources for this page

Verify at the official NPI Registry.