| Hurtt Family Health Clinic Inc. | |
|
1 Hope Drive Tustin CA 92782-0221 | |
| (714) 247-0300 | |
| (714) 259-1598 |
| Full Name | Hurtt Family Health Clinic Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Hope Drive, Tustin, California |
| Authorized Official Name and Position | Becky Carter (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7142478044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hurtt Family Health Clinic Inc. 1 Hope Drive Tustin CA 92782-0221 Ph: (714) 247-0300 | Hurtt Family Health Clinic Inc. 1 Hope Drive Tustin CA 92782-0221 Ph: (714) 247-0300 |
| NPI Number | 1306965587 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 11/26/2019 |
| Medicare PECOS PAC ID | 4183764814 |
|---|---|
| Medicare Enrollment ID | O20110203000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306965587 | NPI | - | NPPES |
| CMM70904F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Stefan T Reynoso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437207404 PECOS PAC ID: 3577509959 Enrollment ID: I20050707000589 |
| Provider Name | Robert F Bader |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225111610 PECOS PAC ID: 5799764874 Enrollment ID: I20111129000374 |
| Provider Name | Yasaman Omidvar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235366584 PECOS PAC ID: 5193986115 Enrollment ID: I20120418000192 |
| Provider Name | Peter C Hung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093027724 PECOS PAC ID: 1052575057 Enrollment ID: I20120601000436 |
| Provider Name | William W Beacom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568894962 PECOS PAC ID: 8022245224 Enrollment ID: I20131213001555 |
| Provider Name | Kazi Rezai |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386962686 PECOS PAC ID: 9739310863 Enrollment ID: I20140403001169 |
| Provider Name | Cindy Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679712947 PECOS PAC ID: 0446443998 Enrollment ID: I20140930001219 |
| Provider Name | Loan T Ha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386062248 PECOS PAC ID: 8921318916 Enrollment ID: I20151103001900 |
| Provider Name | Carol Jean Uebelacker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891767240 PECOS PAC ID: 4082675913 Enrollment ID: I20160216002712 |
| Provider Name | Tameika C Timmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326283557 PECOS PAC ID: 9739468224 Enrollment ID: I20161128002744 |
| Provider Name | Jonathan R Chhean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003786 PECOS PAC ID: 3476809252 Enrollment ID: I20180710000119 |
| Provider Name | Mohini S Bolkhovitinov |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265857049 PECOS PAC ID: 6002154432 Enrollment ID: I20190211001858 |
| Provider Name | Nichola Clemens Linamen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265916944 PECOS PAC ID: 7315285251 Enrollment ID: I20190219000914 |
| Provider Name | Michelle Rhyner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093291056 PECOS PAC ID: 8729312913 Enrollment ID: I20190621000507 |
| Provider Name | Christina Vu Vo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245756402 PECOS PAC ID: 4183954241 Enrollment ID: I20191002003750 |
| Provider Name | Steven Richard Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255846390 PECOS PAC ID: 8325471881 Enrollment ID: I20191214000226 |
| Provider Name | Myra Curiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154980746 PECOS PAC ID: 1052746674 Enrollment ID: I20200108002053 |
| Provider Name | Susana Ortega Rios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720507437 PECOS PAC ID: 8729417670 Enrollment ID: I20200527001771 |
| Provider Name | Warren T Yamashita |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982137691 PECOS PAC ID: 3678993433 Enrollment ID: I20201015002454 |
| Provider Name | Jonathan Wada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780995068 PECOS PAC ID: 3779707401 Enrollment ID: I20210802002586 |
| Provider Name | Brittani Nichole Ehrhorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912528829 PECOS PAC ID: 4688053853 Enrollment ID: I20220617001005 |
| Provider Name | Suneun Sarah Reichert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083031769 PECOS PAC ID: 0749666089 Enrollment ID: I20221010002690 |
| Provider Name | Veronica Elisa Aguilar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588169007 PECOS PAC ID: 9739583881 Enrollment ID: I20221022000225 |
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