GABRIEL ICF (NPI# 1104976794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104976794 |
| Entity Type | Organization |
| Organization Name | GABRIEL ICF |
| Practice Address |
2155 W Elm Street Lodi CA 95242-6703 |
| Mailing Address |
2216 Alpine Dr Lodi CA 95240-6703 |
| Practice Telephone | 2093330592 |
| Practice Fax Number | 2093682771 |
| Mailing Telephone | 2093330592 |
| Mailing Fax Number | 2093682771 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2008-05-07 |
| Authorized Official Name | MRS. ELENA PAISTE GABRIEL (ADMINISTRATOR RN) |
| Authorized Official Telephone | 2095981436 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | LTC80160F | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC80160F | 05 |
| Street Address |
2155 W ELM STREET |
| City | LODI |
| State | CA |
| Zip Code | 95242-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285125807 | Victoria Galvez | Psychologist | 1103 Tudor St, Lodi, CA 95242 | 2018-05-21 |
| 1174931471 | Shuk Mei Chung | Physician Assistant | 2122 W Kettleman Ln, Lodi, CA 95242 | 2014-07-30 |
| 1275962169 | Sharon Elizabeth Palmer | Speech-Language Pathologist | 1200 W Tokay St, Lodi, CA 95242 | 2013-11-01 |
| 1114286093 | Brandee Lyn Smith | Speech-Language Pathologist | 1547 Lexington Dr, Lodi, CA 95242 | 2012-05-11 |
| 1255609509 | Jennifer Marie Wallmark | Speech-Language Pathologist | 8 S. Cambridge Dr., Lodi, CA 95242 | 2011-12-01 |
| 1649459546 | Kimberly Ann White | Counselor | 441 S. Ham Lane Suite A, Lodi, CA 95242 | 2007-10-26 |
| 1255541991 | Heather Baldauff | Occupational Therapist | 800 South Lower Sacramento Road, Lodi Memorial Hospital West, Lodi, CA 95242 | 2007-05-23 |
| 1730227182 | Clifford John Bradshaw | Dentist | 801 S Ham Lane, Suite D, Lodi, CA 95242 | 2007-02-01 |
| 1861541799 | Catherine Ann Gravish | Physical Therapist | 800 South Ham Lane, Lodi, CA 95242 | 2007-01-09 |
| 1497814511 | Stewart Chiropractic Corp | Chiropractor | 1420 W Kettleman Ln #k-1, Lodi, CA 95242 | 2006-12-06 |
| Find all providers in zip 95242 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619132198 | Eugenio Fajardo Reyes | Intermediate Care Facility, Mentally Retarded | 3261 W Sargent Rd, Lodi, CA 95242-9212 | 2008-07-23 |
| 1013183581 | Gabriel Care Home Inc | Intermediate Care Facility, Mentally Retarded | 2216 Alpine Dr, Lodi, CA 95240-6703 | 2008-05-05 |
| 1679749139 | Gabriel Care Home Inc | Intermediate Care Facility, Mentally Retarded | 4617 E Bearcreek Road, Lodi, CA 95240 | 2008-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1841811791 | Young Walker Inc. | Intermediate Care Facility, Mentally Retarded | 14 Deer Ct, Sacramento, CA 95823-4402 | 2020-05-01 |
| 1003441155 | Sunrise Premier Homes LLC | Intermediate Care Facility, Mentally Retarded | 13831 Ruther Ave, Paramount, CA 90723-2662 | 2020-03-10 |
| 1649805912 | Jingma Inc | Intermediate Care Facility, Mentally Retarded | 34909 Osprey Dr, Union City, CA 94587-4618 | 2020-03-07 |
| 1124661699 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 581 S Gilmar St, Anaheim, CA 92802-1306 | 2019-10-28 |
| 1467095935 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 1592 W Lorane Way, Anaheim, CA 92802-3930 | 2019-10-28 |
| 1992348460 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 5940 Los Angeles Way, Buena Park, CA 90620-2723 | 2019-10-28 |
| 1578106043 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2918 E Greenhedge Ave, Anaheim, CA 92806-3804 | 2019-10-28 |
| 1790328680 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 2143 W Fir Ave, Anaheim, CA 92801-3436 | 2019-10-23 |
| 1356984249 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 6540 Christine Cir, Buena Park, CA 90620-4511 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
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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.