RADY CHILDREN'S HOSPITAL (NPI# 1548478597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548478597 |
| Entity Type | Organization |
| Organization Name | RADY CHILDREN'S HOSPITAL |
| Practice Address |
9400 Ruffin Ct Building B San Diego CA 92123-5300 |
| Mailing Address |
3020 Childrens Way Mc 5010 San Diego CA 92123-4223 |
| Practice Telephone | 8585145644 |
| Practice Fax Number | 8589668528 |
| Mailing Telephone | 8589665817 |
| Mailing Fax Number | 8589665828 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MISS ROGER G ROUX (SR VICE PRESIDENT CFO) |
| Authorized Official Telephone | 8585761700 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629219845 | Rady Children's Hospital | Psychologist | 3020 Childrens Way # Mc5081, San Diego, CA 92123-4223 | 2009-03-18 |
| 1316183999 | Rady Children's Hospital | Clinic/Center | 200 W Arbor Dr # Mc8450, San Diego, CA 92103-9001 | 2009-01-01 |
| 1366658239 | Rady Children's Hospital | Medicare Defined Swing Bed Unit | 4690 Coconino Way, San Diego, CA 92117-2612 | 2007-05-15 |
| 1003184862 | Rady Children's Hospital | General Acute Care Hospital | 3020 Children's Way, San Diego, CA 92123 | 2011-12-08 |
| 1477837680 | Rady Children's Hospital | Psychiatric Unit | 3605 Vista Way, Oceanside, CA 92056-4565 | 2011-10-06 |
| 1508172669 | Rady Children's Hospital | Special Hospital | 3665 Kearny Villa Rd Ste 501, San Diego, CA 92123-1953 | 2010-08-27 |
| 1659562429 | Rady Children's Hospital | Speech-Language Pathologist | 3020 Childrens Way, Mc 5010, San Diego, CA 92123-4223 | 2007-08-07 |
| 1033235718 | Rady Children's Hospital | Social Worker | 3020 Childrens Way, Mc 5014, San Diego, CA 92123-4223 | 2007-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RADY CHILDREN'S HOSPITAL-SAN DIEGO | 3020 Childrens Way, San Diego, CA 92123-4223 |
| Street Address |
9400 RUFFIN CT BUILDING B |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396847299 | Joan Sandra Gildin | Psychiatry & Neurology | 9400 Ruffin Ct, B, San Diego, CA 92123-5300 | 2006-09-01 |
| 1497361026 | Laura Anett Jimenez | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5399 | 2020-09-18 |
| 1770104382 | Shaun Michael Higley | Marriage & Family Therapist | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2020-05-05 |
| 1841822350 | Jazmin Andrea Zavala | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2020-02-12 |
| 1679124267 | Katherine Winstead | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-09-25 |
| 1497309991 | Tanya Zazueta | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-08-01 |
| 1851943765 | Nancy Cooper | Registered Nurse | 9400 Ruffin Ct, San Diego, CA 92123-5399 | 2019-07-10 |
| 1639630577 | Mayra Rodriguez | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-03-25 |
| 1598225948 | Ashley Lizbeth Lopez | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-03-21 |
| 1205390820 | Stephanie Soto | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-01-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1114216611 | John Kitchin | Psychiatric Unit | 720 Amiford Dr, San Diego, CA 92107-4204 | 2011-04-05 |
| 1750614764 | Rady Children's Hospital-san Diego | Psychiatric Unit | 3665 Kearny Villa Road, Suite 165, San Diego, CA 92123 | 2009-09-09 |
| 1114054277 | Rady Children's Hospital-san Diego | Psychiatric Unit | 9550 Carmel Mountain Rd, Out Patient Psychiatry, San Diego, CA 92129-2738 | 2007-02-27 |
| 1437627312 | Alvarado Hospital, LLC | Psychiatric Unit | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2018-11-08 |
| 1578094025 | Rady Children's Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-03-27 |
| 1053674564 | Rady Children's Hospital - San Diego | Psychiatric Unit | 3020 Childrens Way, San Diego, CA 92123-4223 | 2012-06-19 |
| 1205121449 | Ucsd Dept. of Psychiatry | Psychiatric Unit | 140 Arbor Dr, San Diego, CA 92103-2007 | 2011-06-16 |
| 1497047724 | San Diego County Mental Health Hospital | Psychiatric Unit | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2011-05-04 |
| 1467752840 | San Diego County Psychiatric Hospital | Psychiatric Unit | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2010-11-01 |
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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.