CORRECTIONS AND REHABILITATION (NPI# 1124648712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124648712 |
| Entity Type | Organization |
| Organization Name | CORRECTIONS AND REHABILITATION |
| Practice Address |
2100 Peabody Road Vacaville CA 95687 |
| Mailing Address |
P.o. Box 4000 Vacaville CA 95696-4000 |
| Practice Telephone | 7074510182 |
| Practice Fax Number | 7074543400 |
| Mailing Telephone | 7074510182 |
| Mailing Fax Number | 7074543400 |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | DR. ROBERT STEVEN THARRATT (STATEWIDE CHIEF MEDICAL EXECUTIVE) |
| Authorized Official Telephone | 9166919913 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CORRECTIONS AND REHABILITATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| California State Prison Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1265067086 | Corrections and Rehabilitation | Pharmacy | 7018 Blair Road, Calipartia, CA 92233 | 2020-03-12 |
| 1134754955 | Corrections and Rehabilitation | Pharmacy | 22844 Virginia Blvd., California City, CA 93505 | 2020-03-12 |
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1427684257 | Corrections and Rehabilitation | Pharmacy | 24863 W. Jayne Avenue, Coalinga, CA 93210 | 2020-03-12 |
| 1356976179 | Corrections and Rehabilitation | Pharmacy | 19005 Wileys Well Road, Blythe, CA 92225 | 2020-03-12 |
| 1326673146 | Corrections and Rehabilitation | Pharmacy | 23500 Kasson Rd Rm 180, Tracy, CA 95304-9595 | 2020-03-12 |
| 1528694379 | Corrections and Rehabilitation | Pharmacy | 21633 Avenue 24 Bldg 1101 Rm 173, Chowchilla, CA 93610-0099 | 2020-03-12 |
| 1417583287 | Corrections and Rehabilitation | Pharmacy | 31626 Highway 101 Dmh Administration Ste 606, Soledad, CA 93960-1020 | 2020-03-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CORRECTIONS AND REHABILITATION, DEPARTMENT OF | 560 E Natoma St, Folsom, CA 95630-2233 |
| Street Address |
2100 PEABODY ROAD |
| City | VACAVILLE |
| State | CA |
| Zip Code | 95687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942365358 | Alvaro Cruz Traquina | Surgery | 2100 Peabody Road, Medical Modular, Vacaville, CA 95687 | 2006-12-26 |
| 1396150470 | David Schuh | Pharmacist | 2100 Peabody Road, Csp-solano/department of Pharmacy, Vacaville, CA 95696 | 2014-06-26 |
| 1649610627 | Dorann Lee Boulian | Psychologist | 2100 Peabody Road, Vacaville, CA 95695-4000 | 2013-07-05 |
| 1972775336 | Segundina Agustin Yancha | Psychiatry & Neurology | 2100 Peabody Road, Csp Solano, Vacaville, CA 95687 | 2008-03-26 |
| 1730364506 | Paul William Sheeran | Dentist | 2100 Peabody Road, Vacaville, CA 95087 | 2007-12-29 |
| 1821272733 | Rita Dacia Mcintyre | Dentist | 2100 Peabody Road, Vacaville, CA 95696-4000 | 2007-12-27 |
| 1356548119 | Khin Mg Win | Internal Medicine | 2100 Peabody Road, Vacaville, CA 95696-4000 | 2007-06-27 |
| 1437355476 | Kathleen Anne Mahon Howe | Nurse Practitioner | 2100 Peabody Road, Vacaville, CA 95696 | 2007-06-26 |
| 1720297575 | Tesie Rafael Rallos | Internal Medicine | 2100 Peabody Road, Vacaville, CA 95686 | 2007-05-21 |
| 1912116864 | Alfredo Quicho Noriega | Surgery | 2100 Peabody Road, Vacaville, CA 95687 | 2007-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992311815 | Azul Center for Integration | Community/Behavioral Health | 186 Isle Royal Circle, Vacaville, CA 95687 | 2020-09-16 |
| 1740813062 | Adenike C. Ogunleye | Nurse Practitioner | California Medical Facility, 1600, California Drive, Fairfield, CA 95687 | 2020-02-14 |
| 1972165249 | Jean Callaghan-hoskins | Behavior Technician | 614 Harvard Ave, Vacaville, CA 95687 | 2019-07-08 |
| 1508338054 | Integrative Foot and Ankle Center | Durable Medical Equipment & Medical Supplies | 600 Nut Tree Rd Ste 210, Vacaville, CA 95687 | 2018-12-21 |
| 1164930640 | Alicia Nicole Gambetti | Family Medicine | 241 Nut Tree Rd., Vacaville, CA 95687 | 2018-01-18 |
| 1437564051 | Errie D. Bohanon | Social Worker | 1600 California St, Vacaville, CA 95687 | 2014-06-23 |
| 1467715177 | Patrick Fisher | Urology | 770 Mason Sst, Vacaville, CA 95687 | 2012-06-18 |
| 1285991968 | Tshering Wangmo Bhutia | Psychiatry & Neurology | 1600 California Drive, Department of Corrections & Reha, California Medicine Family, Psychiatry, Inpatient Progr, Vacaville, CA 95687 | 2012-04-18 |
| 1043589294 | Mantena and Ghazal Dental Corporation | Dentist | 110 Nut Tree Parkway, Vacaville, CA 95687 | 2011-12-16 |
| 1346527074 | Jason Michael Vojkufka | Physical Therapist | 585 Nut Tree Court, Vacaville, CA 95687 | 2011-11-09 |
| Find all providers in zip 95687 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346477536 | Kaiser Foundation Health Plan Inc | Pharmacy | 1 Quality Dr Fl 4, Specialty Care Bldg, Vacaville, CA 95688-9494 | 2009-06-16 |
| 1144470931 | Consonus Pharmacy Services Ca North LLC | Pharmacy | 2148 Icon Way Ste 100, Vacaville, CA 95688-8803 | 2008-09-29 |
| 1124175443 | Kaiser Foundation Health Plan Inc | Pharmacy | 1 Quality Dr Fl A1, Vacaville, CA 95688-9494 | 2007-01-05 |
| 1336221118 | Nugget Market Pharmacy | Pharmacy | 130 Browns Valley Pkwy, Vacaville, CA 95688-3062 | 2006-10-20 |
| 1619502432 | Corrections and Rehabilitation | Pharmacy | 1600 California Drive, Vacaville, CA 95696 | 2020-03-12 |
| 1871727891 | Kaiser Foundation Hospitals | Pharmacy | 1 Quality Dr, Vacaville, CA 95688-9494 | 2009-05-05 |
| 1477590131 | Albertsons LLC | Pharmacy | 777 E Monte Vista Ave, Vacaville, CA 95688-2920 | 2006-06-01 |
| 1104863877 | Albertsons LLC | Pharmacy | 1979 Peabody Rd, Vacaville, CA 95687-6288 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
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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.