RAFAEL CONVALESCENT HOSPITAL (NPI# 1124178645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124178645 |
| Entity Type | Organization |
| Organization Name | RAFAEL CONVALESCENT HOSPITAL |
| Practice Address |
234 N San Pedro Rd San Rafael CA 94903-2858 |
| Practice Telephone | 4154793450 |
| Practice Fax Number | 4154723723 |
| Mailing Telephone | 4154793450 |
| Mailing Fax Number | 4154723723 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TIMOTHY EGAN (ADMINISTRATOR) |
| Authorized Official Telephone | 4154793450 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZR05310F4 | 05 |
| Street Address |
234 N SAN PEDRO RD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346854908 | Molly Rose Stark | Occupational Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2020-09-01 |
| 1104438100 | Dominique Javier | Physical Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2020-08-20 |
| 1013561844 | Peter Howell Behr IIi | Occupational Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2019-07-30 |
| 1790338804 | Brandon Brown | Physical Therapy Assistant | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2019-07-17 |
| 1073078440 | Kristen Reay | Occupational Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2019-02-09 |
| 1912487539 | Julianna Frances Clark | Occupational Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2018-08-14 |
| 1821577750 | Audre Suzanne | Physical Therapist | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2018-08-10 |
| 1952849572 | Marinidence Opco, LLC | Skilled Nursing Facility | 234 N San Pedro Rd, San Rafael, CA 94903-2858 | 2017-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| 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 |
|---|---|---|---|---|
| 1689053274 | Northgate Postacute Care | Skilled Nursing Facility | 40 Professional Center Parkway, San Rafael, CA 94903-2703 | 2015-05-28 |
| 1639506371 | San Rafael Care Center, Inc. | Skilled Nursing Facility | 40 Professional Center Pkwy, San Rafael, CA 94903-2703 | 2013-09-26 |
| 1811049026 | Cf San Rafael, LLC | Skilled Nursing Facility | 81 Professional Center Parkway, San Rafael, CA 94903 | 2007-01-17 |
| 1578675468 | Cal-coast Healthcare, Inc. | Skilled Nursing Facility | 81 Professional Center Pkwy, San Rafael, CA 94903-2702 | 2006-08-31 |
| 1417977299 | Smith Ranch Care Center, LLC | Skilled Nursing Facility | 1550 Silveira Pkwy, San Rafael, CA 94903-4879 | 2006-07-21 |
| 1548293327 | Villa Marin Homeowners Association | Skilled Nursing Facility | 100 Thorndale Drive, San Rafael, CA 94903 | 2006-07-08 |
| 1376515817 | Fmsc San Rafael Operating Company Lp | Skilled Nursing Facility | 45 Professional Center Pkwy, San Rafael, CA 94903-2702 | 2006-02-07 |
| 1497738363 | Aldersly, Inc | Skilled Nursing Facility | 326 Mission Ave, San Rafael, CA 94901-3425 | 2005-11-23 |
| 1609877950 | Nazareth House | Skilled Nursing Facility | 245 Nova Albion Way, San Rafael, CA 94903-3539 | 2005-08-09 |
| 1023534443 | Ghc of San Rafael, LLC | Skilled Nursing Facility | 1550 Silveira Pkwy, San Rafael, CA 94903-4879 | 2017-08-17 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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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.