PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA (NPI# 1750309837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750309837 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA |
| Other Organization Name | PROVIDENCE HOLY CROSS MEDICAL CENTER |
| Practice Address |
11600 Indian Hills Rd Building A Mission Hills CA 91345-1225 |
| Mailing Address |
Po Box 541050 Los Angeles CA 90054-1050 |
| Practice Telephone | 8183658051 |
| Practice Fax Number | 8184964569 |
| Mailing Telephone | 3103037143 |
| Mailing Fax Number | 3103037575 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-05-23 |
| Authorized Official Name | MR. DAVID MAST (CFO) |
| Authorized Official Telephone | 8188473345 |
| 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 |
|---|---|---|---|
| AR | BLUE SHIELD PROV# | ZZZA1901Z | 01 |
| CA | LTC70041G | 05 | |
| CA | ZZT18872G | 05 | |
| CA | BLUE CROSS PROV# | 555074 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Holy Cross Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497241541 | Providence Health System - Southern California | Community/Behavioral Health | 1386 W 7th St # A, San Pedro, CA 90732-3517 | 2018-07-02 |
| 1477647444 | Providence Health System - Southern California | Skilled Nursing Facility | 10425 Magnolia Blvd, North Hollywood, CA 91601-4109 | 2006-10-03 |
| 1770639809 | Providence Health System - Southern California | Skilled Nursing Facility | 1322 W 6th St, San Pedro, CA 90732-3501 | 2007-01-25 |
| 1700808383 | Providence Health System - Southern California | Skilled Nursing Facility | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2006-07-24 |
| 1821019514 | Providence Health System - Southern California | Rehabilitation Unit | 1300 W 7th St, San Pedro, CA 90732-3505 | 2006-07-21 |
| 1902824758 | Providence Health System - Southern California | Rehabilitation Unit | 15031 Rinaldi St, Mission Hills, CA 91345-1207 | 2006-07-18 |
| 1669490819 | Providence Health System - Southern California | Rehabilitation Unit | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2006-07-17 |
| 1154349371 | Providence Health System - Southern California | Psychiatric Unit | 1300 W 7th St, San Pedro, CA 90732-3505 | 2006-07-17 |
| 1477587632 | Providence Health System - Southern California | General Acute Care Hospital | 15031 Rinaldi St, Mission Hills, CA 91345 | 2006-07-11 |
| 1336173269 | Providence Health System - Southern California | General Acute Care Hospital | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2006-07-10 |
| Street Address |
11600 INDIAN HILLS RD BUILDING A |
| City | MISSION HILLS |
| State | CA |
| Zip Code | 91345-1225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720082654 | Carol Susannah Ashe | Nurse Practitioner | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2005-06-09 |
| 1144671140 | Joyce Ellis | Registered Nurse | 11600 Indian Hills Rd, Suite 200b, Mission Hills, CA 91345-1225 | 2016-06-30 |
| 1770934341 | Silvina Kroetz | Dietitian, Registered | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2016-06-24 |
| 1093101065 | Archana Kulai | Family Medicine | 11600 Indian Hills Rd, Mission Hills, CA 91345 | 2015-04-07 |
| 1104229178 | Dyane Gatmaitan | Nurse Practitioner | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2014-10-03 |
| 1053733584 | Sara Wong | Internal Medicine | 11600 Indian Hills Rd, Suite 200, Mission Hills, CA 91345-1225 | 2014-01-17 |
| 1144594045 | Claudio Alberto Rivera | Internal Medicine | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2012-02-24 |
| 1972870301 | Lindsay Navarrete | Clinic/Center | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2011-11-30 |
| 1831489350 | Joanne M Fierro | Nurse Practitioner | 11600 Indian Hills Rd, Mission Hills, CA 91345-1225 | 2011-04-18 |
| 1801109038 | Hooman Dehghan | Internal Medicine | 11600 Indian Hills Rd, Mission Hills, CA 91345 | 2010-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141499 | Alpha Hospice | Hospice Care, Community Based | 15455 Devonshire St Suite 100a, Mission Hills, CA 91345 | 2020-10-12 |
| 1740725639 | Vivian Insua-lopez, Psy.d, Psychologist, Inc | Psychologist | 15455 San Fernando Misson Blvd., #308, Mission Hills, CA 91345 | 2016-12-30 |
| 1699162941 | Nancy M Kim Inc | Family Medicine | 11550 Indiana Hills Rd, 301, Mission Hills, CA 91345 | 2015-04-23 |
| 1881940088 | Prohealth-valley Occupational Medical Group | Clinic/Center | 10630 Sepulveda Blvd., Suite 100, Mission Hills, CA 91345 | 2012-07-25 |
| 1942588868 | Trauma & Critical Care Sfv Group Inc | Surgery | 11550 Indian Hills Road, Suite 310, Mission Hills, CA 91345 | 2011-07-26 |
| 1679860084 | Mirna G Villatoro | Residential Treatment Facility, Physical Disabilities | 11100 Sepulveda Blvd, # 232, Mission Hills, CA 91345 | 2011-07-06 |
| 1093010944 | Ana Yvette Alvarez | Rehabilitation Practitioner | 11565 Laurel Canyon Blvd. Suite 116, Mission Hills, CA 91345 | 2011-01-24 |
| 1811226392 | Tender Home Health | Home Health | 10117 Sepulveda Blvd Ste 205a, Mission Hills, CA 91345 | 2009-12-14 |
| 1033387279 | Jamal Elias Khoury | Chiropractor | 15336 Devonshire St. Ste 3, Mission Hills, CA 91345 | 2008-02-11 |
| 1043497282 | Ana Elena Aldana | Counselor | 10200 Sepulveda Blvd., Unit 100, Mission Hills, CA 91345 | 2008-01-30 |
| Find all providers in zip 91345 | ||||
| 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 |
|---|---|---|---|---|
| 1013478973 | West Coast Congregate, Inc | Skilled Nursing Facility | 14905 Sandra St, Mission Hills, CA 91345-1614 | 2019-03-25 |
| 1437574894 | Vista Care Home Inc. | Skilled Nursing Facility | 10949 Burnet Ave, Mission Hills, CA 91345-1505 | 2014-02-21 |
| 1477555472 | Ararat Home of Los Angeles Inc. | Skilled Nursing Facility | 15099 Mission Hills Rd, Mission Hills, CA 91345-1102 | 2005-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114807 | The Healing Sanctum-greenmeadow, LLC | Skilled Nursing Facility | 5302 E Greenmeadow Rd, Long Beach, CA 90808-1620 | 2020-11-06 |
| 1528667581 | Winterfest Medical Services Corporation | Skilled Nursing Facility | 8758 Winterfest Way, Elk Grove, CA 95624-1295 | 2020-10-21 |
| 1689272528 | Orchards Hc LLC | Skilled Nursing Facility | 1 Amistad Drive, Rancho Mission Viejo, CA 92694 | 2020-10-13 |
| 1083223481 | Santa Clarita Congregate Living Inc | Skilled Nursing Facility | 29830 Wisteria Valley Rd, Santa Clarita, CA 91387-1954 | 2020-07-31 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MISSION HILLS |
| Zip Code | 91345 |
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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.