PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION


Address: 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303
Phone: 3105827312

PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION (NPI# 1770093734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770093734
Entity Type Organization
Organization Name PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
Practice Address 2121 Santa Monica Blvd
Santa Monica
CA 90404-2303
Mailing Address 2020 Santa Monica Blvd Ste 300
Santa Monica
CA 90404-2013
Practice Telephone 3105827312
Mailing Telephone 3105827312
Enumeration Date 2017-10-04
Last Update Date 2017-10-04
Authorized Official Name MR. DONALD W ANDERSON JR. (DIRECTOR - REIMBURSEMENT ADMINISTRA)
Authorized Official Telephone 4255255392
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
N 208000000X Pediatrics Allopathic & Osteopathic Physicians
Y 174400000X Specialist Other Service Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1518438712 Providence Saint Johns Medical Foundation Internal Medicine 2020 Santa Monica Blvd Ste 300, Santa Monica, CA 90404-2013 2018-12-16

Office Location

Street Address 2121 SANTA MONICA BLVD
City SANTA MONICA
State CA
Zip Code 90404-2303

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528062023 Lisa Martine Chaiken Radiology 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2005-06-13
1003428673 Geremy Zhang Registered Nurse 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2020-08-17
1376152082 Jennifer Scheller Student in an Organized Health Care Education/Training Program 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2020-07-28
1710518881 Niceto Lopez, M.d., A.p.c. Internal Medicine 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2020-01-28
1780223412 Genevieve Abanilla Veneracion Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2019-12-28
1013560515 Breanne Grazer Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2019-07-23
1104310002 Michelle Padilla Martinez Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2018-06-15
1952815714 Frania Julianne Ciszewski Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2017-11-30
1609388271 Tara Jean Kays Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2017-11-03
1275059131 Ana Maricela Rocha Nurse Practitioner 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 2017-08-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306453352 Jasmine Burton Physical Therapist 1714 17th Street, Santa Monica, CA 90404 2020-09-24
1003431685 Cintia Haydee Ctibor Behavior Technician 1869 9th Street, Santa Monica, CA 90404 2020-06-10
1073137261 Sydney Kristine Valerio Counselor 1869 9th St, Santa Monica, CA 90404 2020-06-03
1710507082 James Gilbert Cunningham Marriage & Family Therapist 1708 Olympic Blvd, Santa Monica, CA 90404 2020-04-16
1841763687 Crystal Monique Mckinley X Counselor 1865 9th St, Santa Monica, CA 90404 2019-01-04
1952872749 Cesar O Munoz Licensed Vocational Nurse 1865 9th St., Santa Monica, CA 90404 2018-12-06
1023596574 Joseph J Pinzone Md Inc Internal Medicine 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 2018-08-06
1548763535 Alan Rubenstein Dds Inc Dentist 1260 15th St., #703, Santa Monica, CA 90404 2018-03-15
1669993382 Aaron Wilson Counselor 1453 16th Street, Santa Monica, CA 90404 2017-07-03
1922472471 Chianni Lin Acupuncturist 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 2015-11-20
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609405158 Mai Abe Specialist 1333 2nd St Ste 100, Santa Monica, CA 90401-4104 2020-04-06
1205384799 Anna Beata Goslicka Specialist 427 14th St, Santa Monica, CA 90402-2131 2016-09-14
1477917771 Joanna Schafhausen Stover Specialist 1721 21st St, Santa Monica, CA 90404-3916 2016-04-12
1235505637 Andrea Lynn Stein Md A Medical Corporation Specialist 2021 Santa Monica Blvd Ste 730e, Santa Monica, CA 90404-2173 2015-08-19
1942628128 Meghan Jain Specialist 137 Bay St Ste 6, Santa Monica, CA 90405-1026 2014-04-03
1992054464 Nicholas Ulrich Specialist 1821 Wilshire Blvd Ste 400, Santa Monica, CA 90403-5679 2012-08-30
1912180944 Yocheved Schoenes Specialist 1119 Broadway, D, Santa Monica, CA 90401-3028 2007-12-13
1326237058 Pacific Coast Women's Center Specialist 2121 Wilshire Blvd Ste 302, Santa Monica, CA 90403-5743 2007-10-18
1275731242 Ot 4 Kidz, Inc Specialist 1932 14th St, Unit B, Santa Monica, CA 90404-7028 2007-07-11
1174733729 Cynthia Kay Epps Specialist 457 25th St, Santa Monica, CA 90402-3033 2007-05-23
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Competitor

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City SANTA MONICA
Zip Code 90404

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Dataset Information

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.

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