RADY CHILDREN'S HOSPITAL - SAN DIEGO (NPI# 1114091055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114091055 |
| Entity Type | Organization |
| Organization Name | RADY CHILDREN'S HOSPITAL - SAN DIEGO |
| Other Organization Name | RADY CHILDREN'S CONVALESCENT HOSPITAL |
| Practice Address |
3020 Childrens Way # Mc5019 San Diego CA 92123-4223 |
| Practice Telephone | 8589665833 |
| Practice Fax Number | 8589668558 |
| Mailing Telephone | 8589665833 |
| Mailing Fax Number | 8589668558 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | KATHLEEN MARIE CAIN CARRITHERS (SR VP & CHIEF FINANCIAL OFFICER) |
| 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 |
|---|---|---|---|---|---|
| N | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
080000028 | CA | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZT05270G | 05 |
| Other Name | Type Code |
|---|---|
| Rady Children's Convalescent Hospital | Doing Business As Name - 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 |
| 1780756411 | Rady Children's Hospital - San Diego | Nursing Facility/Intermediate Care Facility | 3453 Aveley Pl, San Diego, CA 92111-4727 | 2006-11-15 |
| 1053674564 | Rady Children's Hospital - San Diego | Psychiatric Unit | 3020 Childrens Way, San Diego, CA 92123-4223 | 2012-06-19 |
| 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 # MC5019 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-4223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376618553 | Rady Children's Hospital - San Diego | Skilled Nursing Facility | 3020 Childrens Way # Mc5019, San Diego, CA 92123-4223 | 2006-11-22 |
| 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 | 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 |
| Find all providers in SAN DIEGO | ||||
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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.