FOUNTAINS LA JOLLA SL, LLC (NPI# 1871546887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871546887 |
| Entity Type | Organization |
| Organization Name | FOUNTAINS LA JOLLA SL, LLC |
| Other Organization Name | THE SPRINGS AT PACIFIC REGENT |
| Practice Address |
3884 Nobel Dr San Diego CA 92122-5700 |
| Mailing Address |
2020 W Rudasill Rd Attn: Medicare Billing Tucson AZ 85704-7800 |
| Practice Telephone | 8586258700 |
| Practice Fax Number | 9596258777 |
| Mailing Telephone | 5207974000 |
| Mailing Fax Number | 5207977757 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | GRETA FRUHLING FRAZIER (DIRECTOR) |
| Authorized Official Telephone | 5207974000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 080000401 | CA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| THE SPRINGS AT PACIFIC REGENT | Doing Business As Name - Organization |
| Street Address |
3884 NOBEL DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92122-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962967307 | Kristine Schulte | Physical Therapist | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2019-02-08 |
| 1568926921 | Shannon Landgraf | Speech-Language Pathologist | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2019-01-29 |
| 1962973008 | Brittany Marvin | Physical Therapist | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2018-12-16 |
| 1710421342 | Peter Belvis | Physical Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-12-16 |
| 1255875332 | Latonia Richardson | Occupational Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-12-08 |
| 1326581968 | Shayna Wachendorf | Physical Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-11-30 |
| 1376086918 | Kenneth Sirota | Occupational Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-11-30 |
| 1902349533 | Joy Munoz | Physical Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-11-30 |
| 1447793070 | Edwin Nixon | Physical Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-11-30 |
| 1083157622 | Jennifer Valle | Physical Therapy Assistant | 3884 Nobel Dr, San Diego, CA 92122-5700 | 2016-11-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912561630 | Neal Yacoo | Pharmacist | 9085 Judicial Drive #2137, San Diego, CA 92122 | 2019-04-29 |
| 1598242828 | Gena Rachel Katzer | Social Worker | 3246 Willard St, San Diego, CA 92122 | 2018-07-19 |
| 1164919791 | Janine Marie Battaglia | Nurse Practitioner | Scripps Health Express, 4350 La Jolla Villlage Drive Ste 130, San Diego, CA 92122 | 2018-04-19 |
| 1669991899 | Lindsay Y Ditmars | Pharmacist | 7545 Charmant Dr. #1322, 1322, San Diego, CA 92122 | 2017-09-19 |
| 1154747103 | Rebecca Jackson | Nurse Practitioner | 3655 Nobel Drive, Suite 660, Peak Health Solutions, San Diego, CA 92122 | 2014-03-14 |
| 1851726582 | Grace Lorelei Allen | Doula | 2728 Nansen Avenue, San Diego, CA 92122 | 2013-09-12 |
| 1427301894 | Barry Katzman, M.d., Inc., Apc | Optometrist | 4413 Lajolla Village Dr., Spc. P1, San Diego, CA 92122 | 2012-10-22 |
| 1912295361 | Yingjian Liang | Psychiatry & Neurology | Gillman Drive 9500, San Diego, CA 92122 | 2011-07-19 |
| 1467775486 | David Michael Trejo | Psychologist | 5080 Shoreham Place, Suite 103, San Diego, CA 92122 | 2010-03-04 |
| 1225369556 | Jeffrey J Abrams | Internal Medicine | 3395 Willard St, San Diego, CA 92122 | 2010-01-27 |
| Find all providers in zip 92122 | ||||
| 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 |
|---|---|---|---|---|
| 1336503150 | Jennifer Nichole Dennison | Skilled Nursing Facility | 12400 High Bluff Dr Ste 100, San Diego, CA 92130-3077 | 2016-04-07 |
| 1619360120 | Judy Carol | Skilled Nursing Facility | 3561 Quince St, San Diego, CA 92104-4819 | 2015-03-07 |
| 1730578154 | Roxanne Ferrer | Skilled Nursing Facility | 8029 Calico St, San Diego, CA 92126 | 2015-01-22 |
| 1043609530 | Shipra Sethi | Skilled Nursing Facility | 10850 Sabre Hill Dr Unit 235, San Diego, CA 92128-4120 | 2015-01-21 |
| 1962816140 | Rehab Care | Skilled Nursing Facility | 7335 Park Village Rd, San Diego, CA 92129-4540 | 2014-06-17 |
| 1255609772 | Care With Dignity Healthcare | Skilled Nursing Facility | 9474 Chesapeake Dr, Suite 907, San Diego, CA 92123-1047 | 2011-12-12 |
| 1356584882 | Jenna Bre Marquez | Skilled Nursing Facility | 3373 Kearny Villa Ln, San Diego, CA 92123-1911 | 2009-04-14 |
| 1619193729 | Linda Vista Manor, Inc. | Skilled Nursing Facility | 7675 Family Cir, San Diego, CA 92111-5304 | 2007-04-17 |
| 1912028598 | Uvalde County Hospital Authority | Skilled Nursing Facility | 138 S Fm 1329, San Diego, TX 78384-3925 | 2007-04-02 |
| 1336236496 | Care With Dignity Healthcare, Inc. | Skilled Nursing Facility | 8060 Frost St, San Diego, CA 92123-2703 | 2006-10-09 |
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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.