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Executive Team

Tracy Ream, Chief Executive Officer

Since 1987, Tracy Ream has been CEO of Neighborhood Healthcare. She has led the organization in its growth from a single health center in Escondido to a comprehensive multi-site organization in San Diego and Riverside counties with 650 employees, including more than 80 physicians, psychiatrists, nurse practitioners, dentists, and psychologists.

She has a Master’s in Public Health and has been actively involved in leadership roles within the community health center movement in California, including Health Center Partners of Southern CA and the California Primary Care Association (CPCA )the statewide association of primary care clinics.  She served as Board Chair for CPCA in 2015-2016.


Lisa Daigle, Chief Financial Officer

Lisa Daigle is the Chief Financial Officer at Neighborhood Healthcare.  She has over 25 years experience working in healthcare and 20 years experience working with Federally Qualified Health Centers.  She provides financial consulting services to community health centers in Southern California and has been doing so for over 15 years.

Lisa is a member of the finance committee for the Council of Community Clinics in San Diego and was the 2013 Chair of California Primacy Care Association’s (CPCA) CFO work group.  She represents the San Diego region on many advisory and task force committees throughout California and provides guidance to CPCA staff on financial matters pertaining to Federally Qualified Health Centers.

Lynn Graykowski, Chief Human Resources Officer

Lynn is responsible for preserving the health center’s unique culture of positive engagement with its more than 650 employees, overseeing talent management and development, HR service delivery, diversity and inclusion, HR policies and programs.

Lynn serves on the Personnel Board of Review at the City of Escondido and has served as President for Healthcare Human Resources Management Association (HHRMAC).  She studied Human Resources Management at San Diego State University and is a graduate of Leadership North County through California State University San Marcos.

She is well respected for her commitment to excellence and growing the employees of Neighborhood Healthcare.


Amparo Mahler, Chief Operating Officer

Amparo started at the entry-level position of Patient Services Representative, and through years of dedication and continuing education in health care executive administration and leadership programs from various institutions (such as The UCLA School of management and UCSF- Center for Health Professions) she has moved up to her position as COO. Amparo has been working for Neighborhood Healthcare for over 23 years and has been serving as the COO since 2008. Under her direction, Neighborhood Healthcare serves more than 67,000 individuals annually at eleven clinic locations, providing health education services and comprehensive medical, dental, chiropractic and behavioral health care.

As someone who maintains constant awareness of trends and services, Amparo’s area of special interest is developing and implementing new programs and services to better meet the communities’ needs, helping to keep Neighborhood Healthcare ahead of the curve.  She is well respected for her commitment to excellence, and in 2009 she was honored with the Health Care Champions award from the San Diego Business Journal.  She is part of the working committee for Clinic Leadership Institute at UCSF-Center for the Health Profession and is an active member of the Operation Council for Health Center Partners Network.


Jim Schultz, MD, MBA, FAAFP, Chief Medical Officer

Dr. Jim Schultz has served as the Chief Medical Officer for Neighborhood Healthcare since 2001. Dr. Schultz is a Family Physician who splits time between active patient care and administrative duties. He sees patients in the office at Neighborhood Healthcare and as a very part-time hospitalist at Palomar Medical Center.

Dr. Schultz has been instrumental in growing clinic operations and improving patient access to specialty services. He most recently has led the move to an electronic health record and practice management system and has led and helped implement a robust population health improvement system. He also helped lead changes resulting in accreditation as Patient Centered Medical Homes by the National Committee for Quality Assurance (NCQA).

Dr. Schultz also serves as the Medical Director for Integrated Health Partners and for Project Access San Diego. He is Volunteer Clinical Professor for the UCSD Department of Family and Preventive Medicine and is the co-lead faculty for the Family Medicine Residency Outpatient Gynecology Rotation.

Prior to joining Neighborhood Healthcare, Dr. Schultz served as the President and Medical Director of the Graybill Medical Group in Escondido and San Diego County.  Dr. Schultz completed his family practice residency at Tallahassee Memorial Regional Medical Center a very long time ago. There he served as Chief Resident and was a Resident Director at the Florida Academy of Family Physicians for two years. He received his MD from the University of California, Los Angeles, and his MBA from California State University, San Marcos. He is a diplomate in Wilderness Medicine  (Diploma in Mountain Medicine ) and  is working toward a Fellowship in the Academy of Wilderness Medicine.


Rakesh Patel, MD, FAAFP, CPE Medical Director of Operations

Dr. Patel is a family physician who first joined the medical staff at Neighborhood Healthcare in 2002, as a staff family physician. He has spent most of his career caring for the Middle Eastern refugee population at Neighborhood Healthcare’s  El Cajon site. Over the years, he has moved into more administrative leadership roles.

Currently, Dr. Patel serves as the Medical Director of Operations, where he works to bridge gaps between operational and clinical staff. In his role, not only does he oversee the clinical team leaders at each site but also works closely with site managers to improve care delivery.  He has been an integral team member in working to achieve high clinical quality scores across the organization by mobilizing resources.

Dr. Patel is active in community advocacy. He is a delegate to the CMA as well as on the San Diego County Medical Society Board serving as the East County Region Director.  He also teaches UCSD medical school students as well as Kaiser Family Medicine residents.

Dr. Patel is a board certified family physician who completed his residency at Scripps Family Practice Residency in Chula Vista. He received his MD from the Medical College of Wisconsin. He recently became a Certified Physician Executive and is in the process of completing his MBA at the University of Massachusetts Amherst, Isenberg School of Management.