SHIRLEY'S ICF DD N NO 5 (NPI# 1053563536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053563536 |
| Entity Type | Organization |
| Organization Name | SHIRLEY'S ICF DD N NO 5 |
| Practice Address |
9565 Colington Pl Stockton CA 95209-5013 |
| Mailing Address |
1182 Duvall Ct Stockton CA 95210-3581 |
| Practice Telephone | 2099526027 |
| Practice Fax Number | 2099527829 |
| Mailing Telephone | 2094759829 |
| Mailing Fax Number | 2094759845 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |
| Authorized Official Name | MRS. SHIRLEY E GAPASIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2096079380 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | SHIRLEY'S CARE HOME INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 5500000686 | CA | Nursing & Custodial Care Facilities |
| Street Address |
9565 COLINGTON PL |
| City | STOCKTON |
| State | CA |
| Zip Code | 95209-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417009507 | Shirley's Care Home | Nursing Facility/Intermediate Care Facility | 9565 Colington Pl, Stockton, CA 95209-5013 | 2007-01-17 |
| 1245415272 | Shirley's Care Home Inc | Intermediate Care Facility, Mentally Retarded | 9565 Colington Pl, Stockton, CA 95209-5013 | 2008-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104272954 | William Luther Bennett | Pharmacist | 1131 Sunnyoak Way, Stockton, CA 95209 | 2016-05-11 |
| 1548686769 | Roland Rillamas Lagpacan | Pharmacist | 3131 West Hammer Lane, Stockton, CA 95209 | 2014-03-12 |
| 1346599677 | Luis Leyva Garcia | Marriage & Family Therapist | 1755 West Hammer Lane, Stockton, CA 95209 | 2012-08-31 |
| 1942506233 | Donna Lynn Peterson | Dentist | 9409 Thornton Rd, Stockton, CA 95209 | 2011-02-03 |
| 1386969798 | Miusotic Zaragoza | Social Worker | 1755 W. Hammer Lane Suite 8, Latino Behavioral Health, Stockton, CA 95209 | 2010-03-30 |
| 1497988844 | Marissa Elizabeth Preciado | Counselor | 10147 River Falls Cir, Stockton, CA 95209 | 2009-09-02 |
| 1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
| 1881845790 | Gary Earl Fiscus | Dentist | 4565 Quail Lakes Drive, Suite A-2, Stockton, CA 95209 | 2008-10-09 |
| 1326225665 | Shirley's Care Home Inc | Intermediate Care Facility, Mentally Retarded | 2330 Shropshire Dr, Stockton, CA 95209 | 2008-01-29 |
| 1134272727 | Joanie Mc Culloch | Homeopath | 8807 Thornton Rd, Ste. P, Stockton, CA 95209 | 2007-01-19 |
| Find all providers in zip 95209 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205224334 | Angel's Home Icf, Inc. | Nursing Facility/Intermediate Care Facility | 10712 Waterbury Dr, Stockton, CA 95209-4212 | 2014-12-23 |
| 1730596214 | Solidum Care Home Icf/dd-n #3 | Nursing Facility/Intermediate Care Facility | 8712 Ensenada Dr, Stockton, CA 95210-1213 | 2014-07-17 |
| 1992057244 | Solidum Care Home Icfdd-n#2 | Nursing Facility/Intermediate Care Facility | 9559 Colington Pl, Stockton, CA 95209-5013 | 2012-10-11 |
| 1750687687 | Dhk Manor, Inc | Nursing Facility/Intermediate Care Facility | 4513 Augustus Ct, Stockton, CA 95207-6632 | 2011-02-10 |
| 1285821272 | Solidum Care Homes | Nursing Facility/Intermediate Care Facility | 3522 Otto Dr, Stockton, CA 95209-5138 | 2007-10-03 |
| 1659596856 | Casa Del Rios | Nursing Facility/Intermediate Care Facility | 5541 Solari Ranch Rd, Stockton, CA 95215-9318 | 2007-04-15 |
| 1417009507 | Shirley's Care Home | Nursing Facility/Intermediate Care Facility | 9565 Colington Pl, Stockton, CA 95209-5013 | 2007-01-17 |
| 1700935509 | Duke Facilities, Inc. | Nursing Facility/Intermediate Care Facility | 2661 Otto Dr, Stockton, CA 95209-1111 | 2007-01-09 |
| 1194836163 | City of Stockton | Nursing Facility/Intermediate Care Facility | 315 S Ash St, Stockton, KS 67669-2136 | 2006-08-31 |
| 1124442520 | Solidum Care Home Icf Ddn2 | Nursing Facility/Intermediate Care Facility | 9559 Colington Pl, Stockton, CA 95209-5013 | 2014-02-06 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.