CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. (NPI# 1205477841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205477841 |
| Entity Type | Organization |
| Organization Name | CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. |
| Other Organization Name | SAN YSIDRO HEALTH COMMUNITY HEIGHTS FAMILY MEDICINE |
| Practice Address |
4690 El Cajon Blvd San Diego CA 92115-4403 |
| Mailing Address |
1601 Precision Park Ln San Diego CA 92173-1345 |
| Practice Telephone | 6196624100 |
| Mailing Telephone | 6196624100 |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-11-06 |
| Authorized Official Name | KEVIN MATTSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 6196624100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| San Ysidro Health Community Heights Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851757215 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 330-340 E. 8th St, National City, CA 91950-2312 | 2016-01-14 |
| 1568845741 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 436 S Magnolia Ave Ste 101, El Cajon, CA 92020-5219 | 2015-07-07 |
| 1356750657 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1058 3rd Ave, Chula Vista, CA 91911-2009 | 2014-08-12 |
| 1265843122 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 3364 Beyer Blvd, Suite #102 & #103, San Ysidro, CA 92173-1322 | 2014-05-14 |
| 1538262092 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 950 S Euclid Ave, San Diego, CA 92114-6201 | 2006-09-07 |
| 1922051812 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1637 3rd Ave Ste B, Chula Vista, CA 91911-5823 | 2006-05-19 |
| 1003869363 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1136 D Avenue, National City, CA 91950 | 2006-05-18 |
| 1801438239 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 255 N Ash St Ste 101, Escondido, CA 92027-3069 | 2019-10-17 |
| 1376184911 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 120 Town Center Pkwy, Santee, CA 92071-5801 | 2019-10-04 |
| 1174164719 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1388 Buckman Springs Rd, Campo, CA 91906-2028 | 2019-10-04 |
| Street Address |
4690 EL CAJON BLVD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92115-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346398922 | Tina Lou Wolfe | Psychologist | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2007-01-08 |
| 1164071130 | Alexandra Higdon | Psychologist | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2019-09-11 |
| 1992219539 | Trang Dai Ngoc Nguyen | Nurse Practitioner | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2017-11-17 |
| 1316478092 | Mikayla Todd | Nurse Practitioner | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2017-03-23 |
| 1487011847 | Mountain Health & Community Services, Inc. | Clinic/Center | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2016-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313922 | Mayra Ailed Bugarin | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center 5454, El Cajon Blvd, San Diego, CA 92115 | 2020-04-01 |
| 1093369878 | Chang Liu | Counselor | 3539 College Avenue, San Diego, CA 92115 | 2019-07-30 |
| 1689238560 | Donia Ahadian | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center, 5454 El Cajon Blvd, San Diego, CA 92115 | 2019-04-26 |
| 1780157859 | James Michael Sites | Military Health Care Provider | Uss Shoup Ddg 86, San Diego, CA 92115 | 2019-01-10 |
| 1780163006 | Marcos Luis Sandoval | Case Manager/Care Coordinator | 6224 El Cajon Blvd, Suite 17, San Diego, CA 92115 | 2018-08-08 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| 1982125605 | Ellen Medical Transport | Non-emergency Medical Transport (VAN) | 4587 Winona Ave #5, San Diego, CA 92115 | 2017-07-03 |
| 1992225296 | P'okot LLC | Non-emergency Medical Transport (VAN) | 5511 Adelaide Ave, 26, San Diego, CA 92115 | 2017-06-27 |
| 1578019840 | Alfred Zygmunt Nowak | Specialist/Technologist | 6663 Reservoir Ln, San Diego, CA 92115 | 2016-08-28 |
| 1639534183 | Kalkaal Financial Enterprise, LLC. | Non-emergency Medical Transport (VAN) | 5055 Collwood Blvd., Unit 108, San Diego, CA 92115 | 2015-12-29 |
| Find all providers in zip 92115 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856362 | Family Health Centers of San Diego, Inc | Clinic/Center | 1401 Imperial Ave, San Diego, CA 92101-7527 | 2019-11-21 |
| 1245893072 | Mountain Health & Community Services, Inc. | Clinic/Center | 4440 Euclid Ave Ste C, San Diego, CA 92115-4522 | 2019-04-17 |
| 1093298879 | Family Health Centers of San Diego, Inc | Clinic/Center | 3420 College Ave, San Diego, CA 92115-7134 | 2018-09-08 |
| 1386158483 | Operation Samahan, Inc. | Clinic/Center | 10737 Camino Ruiz Ste 138, San Diego, CA 92126-2361 | 2017-11-28 |
| 1386168193 | San Diego Family Care | Clinic/Center | 6979 Linda Vista Rd, San Diego, CA 92111-6342 | 2017-08-02 |
| 1841714656 | San Diego Family Care | Clinic/Center | 6985 Linda Vista Rd, San Diego, CA 92111-6342 | 2017-08-02 |
| 1699216622 | Operation Samahan Inc | Clinic/Center | 9995 Carmel Mountain Rd, Suite B10 & B11, San Diego, CA 92129-2889 | 2017-03-09 |
| 1235521782 | Family Health Centers of San Diego Inc | Clinic/Center | 2325 Commercial St, Ste 1400, San Diego, CA 92113-1189 | 2015-02-20 |
| 1265831960 | La Maestra Family Clinic, Inc. | Clinic/Center | 4171 Fairmount Ave, San Diego, CA 92105-1609 | 2014-08-19 |
| 1952729303 | Family Health Centers of San Diego Inc | Clinic/Center | 1550 Broadway, Suite 2, San Diego, CA 92101 | 2014-04-02 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.