RADY CHILDREN'S HOSPITAL - SAN DIEGO (NPI# 1053674564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053674564 |
| Entity Type | Organization |
| Organization Name | RADY CHILDREN'S HOSPITAL - SAN DIEGO |
| Other Organization Name | RCHSD - CHILD AND ADOLESCENT PSYCHIATRY SERVICES |
| Practice Address |
3020 Childrens Way San Diego CA 92123-4223 |
| Mailing Address |
3020 Childrens Way Mc 5018 San Diego CA 92123-4223 |
| Practice Telephone | 8589668145 |
| Mailing Telephone | 8589661700 |
| Mailing Fax Number | 8589668470 |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2014-01-15 |
| Authorized Official Name | MR. ROGER G ROUX (SR VP/CFO) |
| Authorized Official Telephone | 8589665824 |
| Is Organization Subpart | Y |
| Parent Organization Name | RADY CHILDREN'S HOSPITAL - SAN DIEGO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 080000028 | CA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 5816515 | 01 |
| Other Name | Type Code |
|---|---|
| RCHSD - CHILD AND ADOLESCENT PSYCHIATRY SERVICES | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245858992 | Rady Children's Hospital - San Diego | Occupational Therapist | 25170 Hancock Ave Ste 175, Murrieta, CA 92562-5969 | 2020-07-09 |
| 1649563065 | Rady Children's Hospital - San Diego | Psychologist | 11752 El Camino Real, Suite 100, San Diego, CA 92130-2050 | 2011-05-18 |
| 1720393176 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 2204 El Camino Real, Suite 102, Oceanside, CA 92054 | 2010-08-10 |
| 1114091055 | Rady Children's Hospital - San Diego | Skilled Nursing Facility | 3020 Childrens Way # Mc5019, San Diego, CA 92123-4223 | 2006-11-20 |
| 1780756411 | Rady Children's Hospital - San Diego | Nursing Facility/Intermediate Care Facility | 3453 Aveley Pl, San Diego, CA 92111-4727 | 2006-11-15 |
| 1639449994 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 3665 Kearny Villa Rd, Suite 405, San Diego, CA 92123-1953 | 2012-01-04 |
| 1154613818 | Rady Children's Hospital - San Diego | Psychologist | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2011-05-12 |
| 1457666802 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 333 H St, Suite 3010, Chula Vista, CA 91910-5555 | 2010-08-10 |
| 1699080051 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 3665 Kearny Villa Rd, Suite 500, San Diego, CA 92123-1953 | 2010-08-10 |
| 1639387681 | Rady Children's Hospital - San Diego | Psychiatric Unit | 3665 Kearny Villa Rd, Suite 440, San Diego, CA 92123-1953 | 2007-05-21 |
| Street Address |
3020 CHILDRENS WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-4223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225036627 | Raymond R Fripp | Pediatrics | 3020 Childrens Way, San Diego, CA 92123-4223 | 2005-07-09 |
| 1306443114 | Nilofar Mansoorgholamshahi | Social Worker | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-10-05 |
| 1245841824 | Farah Jadhavji | Student in an Organized Health Care Education/Training Program | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-08-16 |
| 1508476979 | Erik Cory Galvan | Social Worker | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-07-31 |
| 1932718624 | Julia Newton | Speech-Language Pathologist | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-07-28 |
| 1508484841 | Christian Cacho | Social Worker | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-07-13 |
| 1831714336 | Joyah Korin Brooks | Student in an Organized Health Care Education/Training Program | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-06-10 |
| 1821611195 | Rachel Chaya Lapidus | Student in an Organized Health Care Education/Training Program | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-05-21 |
| 1760005979 | Amani Dawn Piers | Student in an Organized Health Care Education/Training Program | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-05-21 |
| 1497375810 | Frank Lloyd Soriano Armas | Respiratory Therapist, Registered | 3020 Childrens Way, San Diego, CA 92123-4223 | 2020-04-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1114216611 | John Kitchin | Psychiatric Unit | 720 Amiford Dr, San Diego, CA 92107-4204 | 2011-04-05 |
| 1750614764 | Rady Children's Hospital-san Diego | Psychiatric Unit | 3665 Kearny Villa Road, Suite 165, San Diego, CA 92123 | 2009-09-09 |
| 1114054277 | Rady Children's Hospital-san Diego | Psychiatric Unit | 9550 Carmel Mountain Rd, Out Patient Psychiatry, San Diego, CA 92129-2738 | 2007-02-27 |
| 1437627312 | Alvarado Hospital, LLC | Psychiatric Unit | 6655 Alvarado Rd, San Diego, CA 92120-5208 | 2018-11-08 |
| 1578094025 | Rady Children's Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-03-27 |
| 1205121449 | Ucsd Dept. of Psychiatry | Psychiatric Unit | 140 Arbor Dr, San Diego, CA 92103-2007 | 2011-06-16 |
| 1497047724 | San Diego County Mental Health Hospital | Psychiatric Unit | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2011-05-04 |
| 1467752840 | San Diego County Psychiatric Hospital | Psychiatric Unit | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2010-11-01 |
| 1548426687 | Regents of The University of California | Psychiatric Unit | 6535 Alvarado Rd, San Diego, CA 92120-5002 | 2008-07-29 |
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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.