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SAN YSIDRO HEALTH EL CAJON/SAN DIEGO PACE
NPI 1568845741
Clinic/Center - Federally Qualified Health Center (FQHC) in El Cajon, CA

Active since July 07, 2015CLIA 05D2034459 · Waiver
875 EL CAJON BLVD, EL CAJON, CA 92020(619) 662-4100(619) 205-6373 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 30, 2020, Dec 18, 2020, Nov 6, 2018 and 3 more (6 updates tracked since 2016).

About San Ysidro Health El Cajon/san Diego Pace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN YSIDRO HEALTH EL CAJON/SAN DIEGO PACE (NPI 1568845741) is a healthcare organization registered as a federally qualified health center (fqhc) in El Cajon, California and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through June 23, 2028 and lists Kevin Mattson, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1568845741
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Location Address875 EL CAJON BLVDEl Cajon, CA 92020-5714
Mailing Address1601 Precision Park LnSan Diego, CA 92173-1345 · (619) 662-4100
Phone(619) 662-4100
Fax(619) 205-6373
Organization SubpartNo
Authorized OfficialKevin MattsonPresident And Ceo · (619) 662-4100
Enumeration DateJuly 7, 2015
Last NPPES UpdateDecember 30, 20206 updates tracked since enumeration
NPPES CertifiedDecember 30, 2020
✔ NPI 1568845741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
875 EL CAJON BLVD, El Cajon, CA 92020
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Other Names 1

Doing Business AsSan Ysidro Health El Cajon/san Diego Pace

Other Identifiers 1

OtherW5740CA · Part B Ptan

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2034459

San Ysidro Health - El Cajon · El Cajon, CA
Active · expires Jun 23, 2028
CLIA Number05D2034459
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJune 24, 2026
Certificate Expiration DateJune 23, 2028
Laboratory DirectorMaria Carriedo-Ceniceros
Laboratory Phone(619) 205-6392
Laboratory LocationSan Ysidro Health - El Cajon875 El Cajon Blvd, El Cajon, CA 92020
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMARYA NINUS ZAYA
Student in an Organized Health Care Education/Training Program
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
MS. NOOR JANKEEL
Student in an Organized Health Care Education/Training Program
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 806-1054
DR. SUMANA REDDY MD
Allergy & Immunology
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
SAMIRA GEORGES YALDA BH CASE MANAGER
Case Manager/Care Coordinator
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
SHAHDA M ALTAEE
Community Health Worker
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
FAITH JALABE
Peer Specialist
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
KERSTEEN S SHAMOON CM
Case Manager/Care Coordinator
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100
MARIAM KACHI
Social Worker (Clinical)
875 EL CAJON BLVD
EL CAJON, CA 92020
San Diego County (619) 662-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centro De Salud De La Comunidad De San Ysidro, Inc.'s NPI number?

The NPI number for Centro De Salud De La Comunidad De San Ysidro, Inc. is 1568845741. It was assigned to this organization in the NPPES registry on July 7, 2015. The provider is doing business as San Ysidro Health El Cajon/San Diego Pace.

Where is Centro De Salud De La Comunidad De San Ysidro, Inc. located?

Centro De Salud De La Comunidad De San Ysidro, Inc. is located at 875 El Cajon Blvd, El Cajon, CA 92020. The listed phone number is (619) 662-4100.

What is Centro De Salud De La Comunidad De San Ysidro, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Centro De Salud De La Comunidad De San Ysidro, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2034459) is associated with this NPI, valid through June 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centro De Salud De La Comunidad De San Ysidro, Inc. was last updated on December 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.