ST. JOHNS COMMUNITY HEALTH NPI 1396981700

NPI Information

NPI: 1396981700
Provider Name: ST. JOHNS COMMUNITY HEALTH

Former Legal Business Name: ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4085 SOUTH VERMONT AVE
LOS ANGELES, CA
ZIP 90037
Phone: (323) 541-1600
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ST. JOHNS COMMUNITY HEALTH is a federally qualified health center (fqhc) clinic center in Los Angeles, CA. ST. JOHNS COMMUNITY HEALTH NPI is 1396981700. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is St. John's Well Child And Family Center, Inc..

The provider's business location address is:

4085 SOUTH VERMONT AVE
LOS ANGELES, CA
ZIP 90037-045
Phone: (323) 541-1600
Fax: (323) 541-1661

The provider's authorized official is James J Mangia .
The authorized official title is President And Ceo and has the following contact phone number (323) 541-1600.

The enumeration date for this NPI number is 1/7/2009 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator				No
2	171W00000X	Contractor				No
3	251B00000X	Case Management				No
4	251X00000X	Supports Brokerage				No
5	261QC1500X	Clinic/Center	Community Health	550000088	CALIFORNIA	No
6	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1396981700	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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