ST JUDE HOSPITAL INC (NPI# 1033313259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033313259 |
| Entity Type | Organization |
| Organization Name | ST JUDE HOSPITAL INC |
| Other Organization Name | ST JUDE MEDICAL CENTER |
| Practice Address |
2767 E Imperial Hwy Second Floor Brea CA 92821-6713 |
| Mailing Address |
101 E Valencia Mesa Dr Fullerton CA 92835-3809 |
| Practice Telephone | 7148703510 |
| Practice Fax Number | 7148703525 |
| Mailing Telephone | 7149923000 |
| Mailing Fax Number | 7148703525 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2010-08-19 |
| Authorized Official Name | MS. MARGARET ILAGAN (MANAGER, PATIENT FINANCIAL SERVICE) |
| Authorized Official Telephone | 7148703510 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 060000173 | CA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| ST JUDE MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942404165 | St Jude Hospital Inc | Rehabilitation Hospital | 101 E Valencia Mesa Dr, Fullerton, CA 92835-3809 | 2007-06-12 |
| 1194926279 | St Jude Hospital Inc | General Acute Care Hospital | 101 E Valencia Mesa Dr, Fullerton, CA 92835-3809 | 2007-05-29 |
| 1891904942 | St Jude Hospital Inc | General Acute Care Hospital | 2767 E Imperial Hwy, Second Floor, Brea, CA 92821-6713 | 2007-05-22 |
| Street Address |
2767 E IMPERIAL HWY SECOND FLOOR |
| City | BREA |
| State | CA |
| Zip Code | 92821-6713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124066303 | Eleanor Deguzman | Physical Therapist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2006-06-02 |
| 1164899597 | Peter Dooley Iv | Physical Therapist | 2767 E Imperial Hwy, Brea, CA 92821 | 2015-09-02 |
| 1841609096 | Nelson Jay Baje | Physical Therapist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2014-08-12 |
| 1881021137 | Scott Michael Rogoff | Physical Therapist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2013-10-02 |
| 1083052096 | Cortland Nowles Witherspoon | Physical Therapist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2013-06-12 |
| 1740544311 | Wendy Soesman | Occupational Therapist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2012-06-28 |
| 1528358033 | Natalia Covarrubias-eckardt | Physical Medicine & Rehabilitation | 2767 E Imperial Hwy, Brea, CA 92821 | 2011-04-18 |
| 1891904942 | St Jude Hospital Inc | General Acute Care Hospital | 2767 E Imperial Hwy, Second Floor, Brea, CA 92821-6713 | 2007-05-22 |
| 1720117708 | Melissa Claire Soo Hoo | Psychologist | 2767 E Imperial Hwy, Brea, CA 92821-6713 | 2007-03-05 |
| 1558428235 | St. Jude Hospital, Inc. Dba St. Jude Medical Center | General Acute Care Hospital | 2767 E Imperial Hwy, Second Floor, Brea, CA 92821-6713 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844921 | Christina Marie Iezza | Physical Medicine & Rehabilitation | 500 W. Central Ave, Suite B, Brea, CA 92821 | 2020-02-28 |
| 1962052068 | Joanne Chung | Behavioral Analyst | 3050 Saturn Street, #102, Brea, CA 92821 | 2019-09-19 |
| 1508336736 | Sonia Montez | Physical Therapy Assistant | Jump N Schout, 500 W Central Ave, Brea, CA 92821 | 2018-11-30 |
| 1215411921 | Eye View Optometry, Inc | Optometrist | 605 E. Imperial Hwy, Suite C, Brea, CA 92821 | 2018-09-18 |
| 1700395480 | Sheetal Patel | Registered Nurse | 955 W. Imperial Hwy., Suite 220, Brea, CA 92821 | 2017-09-25 |
| 1952827826 | Grace Cho | Occupational Therapist | 875 N Brea Blvd # 600, Brea, CA 92821 | 2017-08-22 |
| 1063959781 | Veronica Meza | Lactation Consultant, Non-RN | 551 Discovery Lane, #115, Brea, CA 92821 | 2017-01-20 |
| 1780045815 | Audrey Alva | Specialist/Technologist | 460 W. Lambert Road, Brea, CA 92821 | 2016-03-17 |
| 1558734921 | Eun Kim Chiropractic Inc | Chiropractor | 411 Atlas Street, Suite A, Brea, CA 92821 | 2015-11-07 |
| 1053784512 | Caremore Health Plan | Nurse Practitioner | 420 W. Central Avenue #a, Brea, CA 92821 | 2015-11-05 |
| Find all providers in zip 92821 | ||||
| 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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| 1629240577 | Thc - Orange County, LLC | Skilled Nursing Facility | 875 N Brea Blvd, Brea, CA 92821 | 2008-04-01 |
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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.