SUNBRIDGE CARE ENTERPRISES WEST LLC (NPI# 1700833977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700833977 |
| Entity Type | Organization |
| Organization Name | SUNBRIDGE CARE ENTERPRISES WEST LLC |
| Other Organization Name | KINGSBURG CENTER |
| Practice Address |
1101 Stroud Ave Kingsburg CA 93631-1016 |
| Practice Telephone | 5598975881 |
| Mailing Telephone | 5598975881 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MICHAEL T. BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684752 |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENCY HEALTH SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 040000209 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZR05573H | 05 |
| Other Name | Type Code |
|---|---|
| Kingsburg Center | Doing Business As Name - Organization |
| Street Address |
1101 STROUD AVE |
| City | KINGSBURG |
| State | CA |
| Zip Code | 93631-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457992711 | Jennifer Elizabeth Fox | Speech-Language Pathologist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2019-10-07 |
| 1518495852 | Alexandria L Alves | Speech-Language Pathologist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2017-05-31 |
| 1457898975 | Brittany Marcelle | Occupational Therapist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2017-01-22 |
| 1184175853 | Lauren Moritz | Physical Therapy Assistant | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2016-10-18 |
| 1619365038 | Kelly Souza | Speech-Language Pathologist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2015-01-07 |
| 1790187771 | Son Truong Vu | Physical Therapist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2014-09-22 |
| 1356769285 | California Emergency Physicians Medical Group A Professional Corp | Internal Medicine | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2014-03-28 |
| 1265855688 | Andrea Marie Porter | Occupational Therapist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2014-01-22 |
| 1518206887 | Scindia Mouttapa | Physical Therapist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2013-02-06 |
| 1952531360 | Hiliary A Fantasia | Occupational Therapist | 1101 Stroud Ave, Kingsburg, CA 93631-1016 | 2009-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336799790 | Eric Lane Silvius | Technician | 2340 18th Avenue, Kingsburg, CA 93631 | 2019-09-18 |
| 1356855647 | Henry Pereschica | Interpreter | 221 Mariposa St, Kingsburg, CA 93631 | 2017-11-22 |
| 1386796423 | Tri County Family Medical Clinic | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-17 |
| 1558665877 | Robert B Stillwagon | Physical Therapist | 392 Sierra St, Kingsburg, CA 93631 | 2010-12-29 |
| 1104074400 | Kingsburg Family Dental | Dentist | 1064 Lewis St, Kingsburg, CA 93631 | 2008-08-29 |
| 1447303268 | Gregory A Dunford | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-18 |
| 1154474971 | Bruce A Trevino | Family Medicine | 2400 Sierra Street, Kingsburg, CA 93631 | 2007-01-18 |
| 1790792356 | Model Drug Inc | Pharmacy | 1506 Draper St, Kingsburg, CA 93631 | 2006-08-03 |
| 1699760090 | Shaunna Shortes | Family Medicine | Po Box 472, Kingsburg, CA 93631-0472 | 2005-09-13 |
| 1386830214 | Kingsburg Joint Union Elementary | Local Education Agency (LEA) | 1310 Stroud Ave, Kingsburg, CA 93631-1000 | 2007-09-25 |
| Find all providers in zip 93631 | ||||
| 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. |
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| 1033737051 | Beautiful Homes Residential Care Inc | Skilled Nursing Facility | 22525 Cerise Ave, Torrance, CA 90505-2913 | 2020-07-07 |
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1881210847 | Ghc of Tem - Snf, LLC | Skilled Nursing Facility | 44320 Campanula Way, Temecula, CA 92592-7903 | 2020-06-24 |
| 1861018327 | Covina Clhf Corporation | Skilled Nursing Facility | 1411 S Sandia Ave, West Covina, CA 91790-3309 | 2020-06-22 |
| 1780204024 | Neighbor Care Congregate Home, Inc. | Skilled Nursing Facility | 3249 Gerald Dr, Newbury Park, CA 91320-2948 | 2020-04-16 |
| 1558998047 | Sunflower Clhf, Inc. | Skilled Nursing Facility | 1058 Ruberta Ave, Glendale, CA 91201-2105 | 2020-03-24 |
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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.