CORRECTIONS AND REHABILITATION (NPI# 1205462769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205462769 |
| Entity Type | Organization |
| Organization Name | CORRECTIONS AND REHABILITATION |
| Practice Address |
480 Alta Road Pharmacy Building Room 122 San Diego CA 92179 |
| Practice Telephone | 6196616500 |
| Practice Fax Number | 6196717588 |
| Mailing Telephone | 6196616500 |
| Mailing Fax Number | 6196717588 |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | DR. ROBERT STEVEN THARRATT (STATEWIDE CHIEF MEDICAL EXECUTIVE) |
| Authorized Official Telephone | 9166919913 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CORRECTIONS AND REHABILITATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Richard J Donovan Correctional Facility Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1265067086 | Corrections and Rehabilitation | Pharmacy | 7018 Blair Road, Calipartia, CA 92233 | 2020-03-12 |
| 1134754955 | Corrections and Rehabilitation | Pharmacy | 22844 Virginia Blvd., California City, CA 93505 | 2020-03-12 |
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1427684257 | Corrections and Rehabilitation | Pharmacy | 24863 W. Jayne Avenue, Coalinga, CA 93210 | 2020-03-12 |
| 1356976179 | Corrections and Rehabilitation | Pharmacy | 19005 Wileys Well Road, Blythe, CA 92225 | 2020-03-12 |
| 1326673146 | Corrections and Rehabilitation | Pharmacy | 23500 Kasson Rd Rm 180, Tracy, CA 95304-9595 | 2020-03-12 |
| 1528694379 | Corrections and Rehabilitation | Pharmacy | 21633 Avenue 24 Bldg 1101 Rm 173, Chowchilla, CA 93610-0099 | 2020-03-12 |
| 1417583287 | Corrections and Rehabilitation | Pharmacy | 31626 Highway 101 Dmh Administration Ste 606, Soledad, CA 93960-1020 | 2020-03-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CORRECTIONS AND REHABILITATION, DEPARTMENT OF | 560 E Natoma St, Folsom, CA 95630-2233 |
| Street Address |
480 ALTA ROAD PHARMACY BUILDING ROOM 122 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730351370 | Malvern C Holland Jr. | Psychologist | 480 Alta Road, R.j. Donovan Correctional Facility, San Diego, CA 92179-0001 | 2008-03-24 |
| 1104343946 | Ruth Ann Villasenor | Social Worker | 480 Alta Road, San Diego, CA 92179 | 2017-08-23 |
| 1235478652 | Craig Teofilo | Psychologist | 480 Alta Road, San Diego, CA 92198 | 2013-02-05 |
| 1902171614 | Alan Greg Springer | Pharmacist | 480 Alta Road, San Diego, CA 92179-0001 | 2012-03-13 |
| 1063657385 | Charles Fielding Marsh | Psychiatry & Neurology | 480 Alta Road, San Diego, CA 92179 | 2008-12-16 |
| 1932374238 | John Charles Preston IIi | Psychiatry & Neurology | 480 Alta Road, San Diego, CA 92179 | 2008-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1508104928 | Paul Hippaka | Social Worker | 408 Alta Road, San Diego, CA 92179 | 2013-01-18 |
| 1518302124 | Antoinette Frances Dorothy Busalacchi | Physician Assistant | 480 Alta Rd, San Diego, CA 92179 | 2013-05-08 |
| 1609049972 | Richard Louis Gomez | Psychiatry & Neurology | 480 Alta Rd, Dept of Mental Health Services Rjdcf, San Diego, CA 92179 | 2008-04-08 |
| 1932371127 | John A. Saunders | Psychiatry & Neurology | 480 Alta Rd, Rjdcf, San Diego, CA 92179 | 2008-03-27 |
| 1760452874 | Ryan Anthony Barenchi | Family Medicine | 480 Alta Rd, San Diego, CA 92179-0001 | 2006-01-23 |
| 1700418878 | Nadia Hortencia Camarillo | Social Worker | 480 Alta Rd, San Diego, CA 92179-0001 | 2020-02-06 |
| 1083265367 | Essence Dawson | Social Worker | 480 Alta Rd, San Diego, CA 92179-0001 | 2019-09-27 |
| 1689184905 | Rushton Arthur Backer | Psychologist | 480 Alta Rd, San Diego, CA 92179-0001 | 2017-10-02 |
| 1285164269 | Colleen Marie Strahan | Pharmacist | 480 Alta Rd, San Diego, CA 92179-0001 | 2017-06-13 |
| Find all providers in zip 92179 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1720607112 | Kaiser Foundation Health Plan Inc | Pharmacy | 6911 Convoy Ct Fl 1 Rm 1501, San Diego, CA 92111-1014 | 2020-04-15 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1942772272 | Rising Star Holdings LLC | Pharmacy | 500 S Dr Ee Dunlap Hwy Ste C, San Diego, TX 78384-3415 | 2018-12-27 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1700245099 | Naval Medical Center San Diego | Pharmacy | Mcas Miramar Exchange Pharmacy, Bldg 2660, San Diego, CA 92126 | 2016-02-16 |
| 1912362377 | Dt Pharmacy Corporation | Pharmacy | 5507 El Cajon Blvd # E, San Diego, CA 92115-3624 | 2015-12-29 |
| 1649600487 | Aids Healthcare Foundation | Pharmacy | 3940 Fourth Avenue, Suite 150, San Diego, CA 92103-7193 | 2013-11-14 |
| 1144574260 | Medpilot Pharmacy Inc. | Pharmacy | 9323 Chesapeake Dr, Suite #c1, San Diego, CA 92123-1044 | 2012-10-29 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on CORRECTIONS AND REHABILITATION.
| 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.