GOOD SHEPHERD HEALTHCARE CENTER OF SANTA MONICA (NPI# 1114090206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114090206 |
| Entity Type | Organization |
| Organization Name | GOOD SHEPHERD HEALTHCARE CENTER OF SANTA MONICA |
| Practice Address |
1131 Arizona Ave Santa Monica CA 90401-2009 |
| Mailing Address |
1101 Crenshaw Blvd Los Angeles CA 90019-3112 |
| Practice Telephone | 3104514800 |
| Practice Fax Number | 3104583156 |
| Mailing Telephone | 3239345660 |
| Mailing Fax Number | 3239340852 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-11-18 |
| Authorized Official Name | MS. JEOUNG HANS LEE (PRESIDENT) |
| Authorized Official Telephone | 3239345660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 910000056 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZT05171H | 05 |
| Street Address |
1131 ARIZONA AVE |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90401-2009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013499458 | Franchesca Johnson Gordon | Marriage & Family Therapist | 900 Wilshire Blvd., Ste. 450, Santa Monica, CA 90401 | 2018-09-01 |
| 1629564083 | Michelle Jillian Dolinsky | Social Worker | 1243 7th St Ste C, Santa Monica, CA 90401 | 2018-07-09 |
| 1528507084 | Doctor Tlc, License Clinical Psychologist, Inc. | Community/Behavioral Health | 1242 Third St Promenade, Suite 208, Santa Monica, CA 90401 | 2017-02-16 |
| 1285006023 | Venessa Leeann Roca | Speech-Language Pathologist | 1218 6th Street, Santa Monica, CA 90401 | 2015-10-20 |
| 1720468036 | Stephen J. Kenneally | Marriage & Family Therapist | 610 Santa Monica Bvd, Ste. 201, Santa Monica, CA 90401 | 2015-06-02 |
| 1629458070 | Dominique L Robertson | Marriage & Family Therapist | 530 Wilshire, #310, Santa Monica, CA 90401 | 2015-06-01 |
| 1205252673 | Santa Monica Sports Medicine Inc. | Physical Medicine & Rehabilitation | 900 Wilshire Blvd. #410, Santa Monica, CA 90401 | 2014-03-10 |
| 1154675023 | Sherry Marie Martyn | Psychologist | 1242 3rd Street Promenade Ste 208, Santa Monica, CA 90401 | 2012-10-31 |
| 1700159829 | Gary Warburton | Dentist | 519 Arizona Ave., Santa Monica, CA 90401 | 2012-02-21 |
| 1265713036 | Aleksandr Mailyan | Reflexologist | 201 Wilshire Blvd #101, Santa Monica, CA 90401 | 2011-09-07 |
| Find all providers in zip 90401 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962557819 | Marksherm, Inc | Skilled Nursing Facility | 1437 14th St, Santa Monica, CA 90404-2703 | 2007-01-23 |
| 1578649810 | Ab Crispino & Company Inc | Skilled Nursing Facility | 2250 29th Street, Santa Monica, CA 90405 | 2006-10-30 |
| 1699857193 | Ab Crispino & Co. Inc | Skilled Nursing Facility | 2828 Pico Blvd, Santa Monica, CA 90405-1920 | 2006-10-20 |
| 1609972520 | Pc Care, LLC | Skilled Nursing Facility | 1323 17th Street, Santa Monica, CA 90404 | 2006-09-16 |
| 1801836622 | Goldstar Healthcare Center of Santa Monica, LLC | Skilled Nursing Facility | 1340 15th St, Santa Monica, CA 90404-1802 | 2006-06-08 |
| 1720051295 | Grancare LLC | Skilled Nursing Facility | 1320 20th St, Santa Monica, CA 90404-2034 | 2006-02-07 |
| 1083687560 | Grancare LLC | Skilled Nursing Facility | 1338 20th St, Santa Monica, CA 90404-2034 | 2006-02-07 |
| 1962487272 | Coastal Health Care, Inc. | Skilled Nursing Facility | 1321 Franklin St, Santa Monica, CA 90404-2603 | 2005-12-08 |
| 1679558175 | F.c.h. Inc. | Skilled Nursing Facility | 947 3rd St, Santa Monica, CA 90403-2599 | 2005-12-07 |
| 1164403739 | Seaport Care Center, L.p. | Skilled Nursing Facility | 1330 17th St, Santa Monica, CA 90404-1902 | 2005-11-09 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90401 |
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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.