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VISTA COMMUNITY CLINIC
NPI 1649662719
Clinic/Center - Federally Qualified Health Center (FQHC) in Lake Elsinore, CA

Active since February 26, 2015
30195 FRASER DR, LAKE ELSINORE, CA 92530(760) 631-5000 Get Directions Write a Review

NPPES record last updated: February 10, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Vista Community Clinic NPPES

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

VISTA COMMUNITY CLINIC (NPI 1649662719) is a healthcare organization registered as a federally qualified health center (fqhc) in Lake Elsinore, California and active in the NPI registry since February 2015. The organization lists Fernando Sanudo, Ceo, as its authorized official.

NPPES Registry Identity

NPI1649662719
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameVISTA COMMUNITY CLINIC
Location Address30195 FRASER DRLake Elsinore, CA 92530-7006
Mailing Address1000 Vale Terrace DrVista, CA 92084-5218 · (760) 631-5000
Phone(760) 631-5000
Organization SubpartNo
Authorized OfficialFernando SanudoCeo · (760) 631-5000
Enumeration DateFebruary 26, 2015
Last NPPES UpdateFebruary 10, 2016
✔ NPI 1649662719 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
30195 FRASER DR, Lake Elsinore, CA 92530
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Other Providers at the Same Location NPPES 8

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

ASHLY ANN VILLARREAL
Social Worker (Clinical)
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (760) 631-5000
DR. HYONG JOON KIM
Dentist (General Practice)
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720
IMELDA GUTIERREZ-HUNT LCSW
Social Worker (Clinical)
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720
DR. CESAR AUGUSTO MAVILA D.C.
Chiropractor
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (844) 308-5003
CARLA PATRICIA CAMPO DDS
Dentist
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720
MS. GAIL ANN MC CABE LCSW
Social Worker (Clinical)
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720
DR. CLINT KETCHEL M.D.
Family Medicine
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720
MRS. OLIVIA DEL VALLE RDH
Dental Hygienist
30195 FRASER DR
LAKE ELSINORE, CA 92530
Riverside County (951) 252-2720

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 Vista Community Clinic's NPI number?

The NPI number for Vista Community Clinic is 1649662719. It was assigned to this organization in the NPPES registry on February 26, 2015.

Where is Vista Community Clinic located?

Vista Community Clinic is located at 30195 Fraser Dr, Lake Elsinore, CA 92530. The listed phone number is (760) 631-5000.

What is Vista Community Clinic's specialty?

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

When was this NPI record last updated?

The NPPES record for Vista Community Clinic was last updated on February 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.