| Livingston Community Health | |
|
600 B St Bldg B Livingston CA 95334-9593 | |
| (209) 394-7913 | |
| (209) 394-3660 |
| Full Name | Livingston Community Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 B St Bldg B, Livingston, California |
| Authorized Official Name and Position | Leslie Tamiko Mcgowan (CEO) |
| Authorized Official Contact | 2093941365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingston Community Health 600 B St Bldg B Livingston CA 95334-9593 Ph: (209) 394-7913 | Livingston Community Health 600 B St Bldg B Livingston CA 95334-9593 Ph: (209) 394-7913 |
| NPI Number | 1427110329 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 04/13/2021 |
| Medicare PECOS PAC ID | 8820084692 |
|---|---|
| Medicare Enrollment ID | O20040426000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427110329 | NPI | - | NPPES |
| ZZZ71885Y | Other | CA | BLUE SHIELD |
| FHC03897F | Medicaid | CA | |
| BCP03897F | Other | CA | BREAST CANCER EARLY DETEC |
| HAP03897F | Other | CA | HEALTH ACCESS PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Susan F Kraus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194708412 PECOS PAC ID: 0446145072 Enrollment ID: I20040220000841 |
| Provider Name | Ana R Revilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083792501 PECOS PAC ID: 5193789006 Enrollment ID: I20041118001159 |
| Provider Name | George M Savage |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063577823 PECOS PAC ID: 0345284576 Enrollment ID: I20050617000403 |
| Provider Name | Glen Villanueva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922018647 PECOS PAC ID: 3072544345 Enrollment ID: I20050825001088 |
| Provider Name | Susie Wenstrup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013020288 PECOS PAC ID: 0749202778 Enrollment ID: I20051219000781 |
| Provider Name | James A Kraus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477580595 PECOS PAC ID: 5890798540 Enrollment ID: I20060817000584 |
| Provider Name | Afnan A Qadeer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083728794 PECOS PAC ID: 4587660816 Enrollment ID: I20061010000610 |
| Provider Name | Samuel D Esparza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750416038 PECOS PAC ID: 9133220866 Enrollment ID: I20070725000591 |
| Provider Name | Augustine Q Provencio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467590158 PECOS PAC ID: 6204866916 Enrollment ID: I20071203000559 |
| Provider Name | John English |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437169224 PECOS PAC ID: 8325129158 Enrollment ID: I20080117000309 |
| Provider Name | Juan Lopez Solorza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295747152 PECOS PAC ID: 6507947348 Enrollment ID: I20080117000411 |
| Provider Name | Mitchell A Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063429843 PECOS PAC ID: 5193895902 Enrollment ID: I20080605000667 |
| Provider Name | Roya K Dehkordi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619149416 PECOS PAC ID: 4183785397 Enrollment ID: I20081205000776 |
| Provider Name | Conrad F Schoenwald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033374715 PECOS PAC ID: 5193877132 Enrollment ID: I20110208001102 |
| Provider Name | Julianah Adenike Olabode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699929042 PECOS PAC ID: 0648451476 Enrollment ID: I20110225000743 |
| Provider Name | Aileen Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699969477 PECOS PAC ID: 8426215054 Enrollment ID: I20120208000952 |
| Provider Name | Leticia Guillen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194851642 PECOS PAC ID: 6800021569 Enrollment ID: I20131105000907 |
| Provider Name | Jerome G Baldonado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316289358 PECOS PAC ID: 1153557657 Enrollment ID: I20131121001012 |
| Provider Name | Elizabeth Anne Buhler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104176999 PECOS PAC ID: 0547493694 Enrollment ID: I20140425001537 |
| Provider Name | Christine Battaglia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558657106 PECOS PAC ID: 5597981449 Enrollment ID: I20140729002475 |
| Provider Name | Amy L Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649679390 PECOS PAC ID: 1254551427 Enrollment ID: I20141010000803 |
| Provider Name | Jose Gerardo Alberto |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780945766 PECOS PAC ID: 6002034758 Enrollment ID: I20150716000347 |
| Provider Name | Carlos Gianpaulo Gasha Tamashiro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063700466 PECOS PAC ID: 2062714439 Enrollment ID: I20160219000966 |
| Provider Name | Richard Lee Moss |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578585717 PECOS PAC ID: 5799082798 Enrollment ID: I20160317002029 |
| Provider Name | Ofelia Ortiz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780611509 PECOS PAC ID: 0648233874 Enrollment ID: I20160622002355 |
| Provider Name | Morgan Theis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124361258 PECOS PAC ID: 8628357415 Enrollment ID: I20161118001017 |
| Provider Name | Yaroon G Kochito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942610464 PECOS PAC ID: 2264752013 Enrollment ID: I20170110002317 |
| Provider Name | Melinda Sue Edmondson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730557596 PECOS PAC ID: 7315255700 Enrollment ID: I20170222000218 |
| Provider Name | Lourdes Maria Apodaca |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952509689 PECOS PAC ID: 4688944077 Enrollment ID: I20170718000960 |
| Provider Name | Megan Mary Greenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740623420 PECOS PAC ID: 6800167990 Enrollment ID: I20171130000816 |
| Provider Name | Anna S Naufahu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942692868 PECOS PAC ID: 6204196843 Enrollment ID: I20180130003085 |
| Provider Name | Rohit Arora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154717213 PECOS PAC ID: 1355696584 Enrollment ID: I20180612001776 |
| Provider Name | Stephanie Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083147730 PECOS PAC ID: 0941572960 Enrollment ID: I20190102002948 |
| Provider Name | Amandeep Kaur Johal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639663248 PECOS PAC ID: 3072859552 Enrollment ID: I20190104001824 |
| Provider Name | Kevin Maurice Mcgauley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205311941 PECOS PAC ID: 6507107554 Enrollment ID: I20190401002210 |
| Provider Name | Beverly Marcella Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568995546 PECOS PAC ID: 5496082000 Enrollment ID: I20190805003390 |
| Provider Name | Jaswinder K Barn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306331699 PECOS PAC ID: 3274860457 Enrollment ID: I20190809002895 |
| Provider Name | Gaganpreet Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821551953 PECOS PAC ID: 2466789524 Enrollment ID: I20190812003266 |
| Provider Name | Edie Laine Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255485751 PECOS PAC ID: 3971770272 Enrollment ID: I20191112001704 |
| Provider Name | Dionetta C Mallory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053965202 PECOS PAC ID: 4981037397 Enrollment ID: I20191125002078 |
| Provider Name | Andrea Elizabeth-mehl Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528690120 PECOS PAC ID: 2769812270 Enrollment ID: I20200424001090 |
| Provider Name | Anita Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720041494 PECOS PAC ID: 5092931485 Enrollment ID: I20200430000624 |
| Provider Name | Annarheen Pineda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932368388 PECOS PAC ID: 8527499698 Enrollment ID: I20200506001016 |
| Provider Name | Karen Ann P Rayos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114300209 PECOS PAC ID: 5496165615 Enrollment ID: I20201029001004 |
| Provider Name | Nancy E Cisneros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104414598 PECOS PAC ID: 6901211556 Enrollment ID: I20210212002053 |
| Provider Name | Nora Mary Vue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316531825 PECOS PAC ID: 4587072590 Enrollment ID: I20210412002115 |
| Provider Name | Raquel A Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164033965 PECOS PAC ID: 7416358148 Enrollment ID: I20210701000776 |
| Provider Name | Chuah Cha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497248033 PECOS PAC ID: 9032536644 Enrollment ID: I20210715001337 |
| Provider Name | Angelica Maria Carranza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730858838 PECOS PAC ID: 7315335585 Enrollment ID: I20211021001314 |
| Provider Name | Christina Maureen Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417614199 PECOS PAC ID: 8022402114 Enrollment ID: I20220307002063 |
| Provider Name | Flor De Maria Lopez Flores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093277345 PECOS PAC ID: 9931582301 Enrollment ID: I20220817002667 |
| Provider Name | Thanya Ryland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811605967 PECOS PAC ID: 2961872122 Enrollment ID: I20230104000596 |
| Provider Name | Linda Sue Jursa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457585523 PECOS PAC ID: 6709058407 Enrollment ID: I20230331001550 |
| Provider Name | Laura Lilia Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942903596 PECOS PAC ID: 3072966720 Enrollment ID: I20240129003764 |
| Provider Name | Leticia Vasquez-zurita |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245652379 PECOS PAC ID: 0749623593 Enrollment ID: I20240208001445 |
| Provider Name | Rosa Delia Carmona Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013426774 PECOS PAC ID: 6305280587 Enrollment ID: I20240215001573 |
| Provider Name | Benjamin Hsieh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164046827 PECOS PAC ID: 2062856560 Enrollment ID: I20240222002610 |
Livingston Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1140 Main St, Livingston, CA 95334 Phone: 209-394-7075 Fax: 209-394-3660 | |
Livingston Health Campus Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 B Street, Suite A, B, C, Livingston, CA 95334 Phone: 209-394-7913 Fax: 209-394-9093 | |
Universal Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1472 B St Ste A, Livingston, CA 95334 Phone: 209-751-7165 Fax: 209-751-7165 | |
Wolves Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1617 Main St, Livingston, CA 95334 Phone: 209-394-7913 Fax: 209-394-3660 | |
Ran Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 517 Main St Ste A, Livingston, CA 95334 Phone: 209-445-2388 Fax: 209-490-5652 | |
Mfa Livingston Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 746 Main St, Livingston, CA 95334 Phone: 209-398-2145 |