ST. JOHN'S RETIREMENT VILLAGE, INC. (NPI# 1114386745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114386745 |
Entity Type | Organization |
Organization Name | ST. JOHN'S RETIREMENT VILLAGE, INC. |
Practice Address |
135 Woodland Ave Woodland CA 95695-2701 |
Practice Telephone | 5306621290 |
Practice Fax Number | 5306620852 |
Mailing Telephone | 5306621290 |
Mailing Fax Number | 5306620852 |
Enumeration Date | 2016-02-10 |
Last Update Date | 2016-02-10 |
Authorized Official Name | MARY THERESE BROWN (CEO) |
Authorized Official Telephone | 5306621290 |
Authorized Official Credential | MSG |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | 5703000654 | CA | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 1891914784 | 05 | |
PTN | 056138 | 01 |
Street Address |
135 WOODLAND AVE |
City | WOODLAND |
State | CA |
Zip Code | 95695-2701 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558432732 | Dynamic Therapy Solutions | Physical Therapist | 135 Woodland Ave, Woodland, CA 95695-2701 | 2006-11-10 |
1124337811 | Christina Smith | Community Health Worker | 135 Woodland Ave, Woodland, CA 95695-2701 | 2010-09-29 |
1366751000 | Dynamic Therapy Solutions Inc. | Clinic/Center | 135 Woodland Ave, Woodland, CA 95695-2701 | 2010-09-29 |
1184872988 | Collenn Cahill Kaff | Speech-Language Pathologist | 135 Woodland Ave, Woodland, CA 95695-2701 | 2008-09-04 |
1255500401 | Judy Stubbs | Occupational Therapy Assistant | 135 Woodland Ave, Woodland, CA 95695-2701 | 2008-02-21 |
1598961781 | Sean Beloud | Physical Therapy Assistant | 135 Woodland Ave, Woodland, CA 95695-2701 | 2007-06-25 |
1720283609 | Sonia Carrasco | Occupational Therapist | 135 Woodland Ave, Woodland, CA 95695-2701 | 2007-06-19 |
1891914784 | St John Retirement Village | Skilled Nursing Facility | 135 Woodland Ave, Woodland, CA 95695-2701 | 2007-04-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346851144 | Tariro Angela Sawaya | Student in an Organized Health Care Education/Training Program | 445 1st Street, Woodland, CA 95695 | 2020-08-14 |
1093277683 | Christie Lynne Vice | Marriage & Family Therapist | 255 W Court St Ste D, Woodland, CA 95695 | 2019-04-02 |
1912479437 | Phillips Scoliosis Center | Chiropractor | 375 W Main St., Ste C-1, Woodland, CA 95695 | 2018-12-21 |
1568947042 | Nikhil Sibal | Dentist | Woodland Family Dental, 58 W Court Street, Woodland, CA 95695 | 2018-10-01 |
1659860849 | Savannah Ellizabeth Lindley | Behavior Technician | 260 West Main St, Woodland, CA 95695 | 2018-05-03 |
1982133344 | Brittanie Ann Akey | Behavior Technician | 1102 Gary Way, Woodland, CA 95695 | 2017-06-08 |
1083163604 | Arthur Hernandez | Nurse Practitioner | 215 West Beamer Street, Woodland, CA 95695 | 2016-09-23 |
1386191856 | Kelly Lee | Registered Nurse | 25 N. Cottonwood St., Adult and Aging Branch, Yolo County Hhsa, Woodland, CA 95695 | 2016-09-01 |
1730634486 | Ida Nilanthi Lonnerdal | Marriage & Family Therapist | 455 First Street, Woodland, CA 95695 | 2016-08-23 |
1912365974 | Yaretzi Counseling and Consulting LLC | Social Worker | 327 College St Ste 105, Woodland, CA 95695 | 2016-02-05 |
Find all providers in zip 95695 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Notes: [7/1/2003: new] |
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1295959534 | Woodland Assisted Living | Assisted Living Facility | 310 4th St, Woodland, WA 98674-8488 | 2007-04-11 |
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1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
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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.