PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA


Address: 1300 W 7th St, San Pedro, CA 90732-3505
Phone: 3108323311

PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA (NPI# 1154349371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154349371
Entity Type Organization
Organization Name PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Practice Address 1300 W 7th St
San Pedro
CA 90732-3505
Mailing Address Po Box 2335
Spokane
WA 99210-2335
Practice Telephone 3108323311
Mailing Telephone 3103037496
Mailing Fax Number 3103037496
Enumeration Date 2006-07-17
Last Update Date 2018-12-24
Authorized Official Name DONALD WAYNE ANDERSON (ASSISTANT SECRETARY - ENROLLMENT)
Authorized Official Telephone 4255255392
Is Organization Subpart Y
Parent Organization Name PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 273R00000X Psychiatric Unit Hospital Units

Other Provider Identifier

State Issuer Identifier Type Code
CA HSM30078G 05
CA BLUE CROSS 05S078 01

Other Provider/Organization Names

Other Name Type Code
Providence Little Company of Mary Medical Center San Pedro Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1497241541 Providence Health System - Southern California Community/Behavioral Health 1386 W 7th St # A, San Pedro, CA 90732-3517 2018-07-02
1477647444 Providence Health System - Southern California Skilled Nursing Facility 10425 Magnolia Blvd, North Hollywood, CA 91601-4109 2006-10-03
1770639809 Providence Health System - Southern California Skilled Nursing Facility 1322 W 6th St, San Pedro, CA 90732-3501 2007-01-25
1700808383 Providence Health System - Southern California Skilled Nursing Facility 501 S Buena Vista St, Burbank, CA 91505-4809 2006-07-24
1821019514 Providence Health System - Southern California Rehabilitation Unit 1300 W 7th St, San Pedro, CA 90732-3505 2006-07-21
1902824758 Providence Health System - Southern California Rehabilitation Unit 15031 Rinaldi St, Mission Hills, CA 91345-1207 2006-07-18
1669490819 Providence Health System - Southern California Rehabilitation Unit 501 S Buena Vista St, Burbank, CA 91505-4809 2006-07-17
1750309837 Providence Health System - Southern California Skilled Nursing Facility 11600 Indian Hills Rd, Building A, Mission Hills, CA 91345-1225 2006-07-17
1477587632 Providence Health System - Southern California General Acute Care Hospital 15031 Rinaldi St, Mission Hills, CA 91345 2006-07-11
1336173269 Providence Health System - Southern California General Acute Care Hospital 501 S Buena Vista St, Burbank, CA 91505-4809 2006-07-10

Office Location

Street Address 1300 W 7TH ST
City SAN PEDRO
State CA
Zip Code 90732-3505

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356323828 Jason C Kantor Radiology 1300 W 7th St, San Pedro, CA 90732-3505 2005-11-18
1598366486 Nina Sabet-peyman, Md Inc. Hospice, Inpatient 1300 W 7th St, San Pedro, CA 90732-3505 2020-11-05
1154922185 Melissa Louise Zankich-patalan Nurse Practitioner 1300 W 7th St, San Pedro, CA 90732-3505 2020-11-05
1063011104 Christina Margarita Villasenor Occupational Therapist 1300 W 7th St, San Pedro, CA 90732-3505 2020-10-20
1073125480 Peguy-emmanuelle Alva Registered Nurse 1300 W 7th St, San Pedro, CA 90732-3505 2020-08-18
1518588433 Southern California Emergency Medical Group Emergency Medicine 1300 W 7th St, San Pedro, CA 90732-3505 2020-05-01
1033748744 Jenna Nicole East Speech-Language Pathologist 1300 W 7th St, San Pedro, CA 90732-3505 2020-04-04
1023654555 Susan Marie Smith Registered Nurse 1300 W 7th St, San Pedro, CA 90732-3505 2019-11-19
1477196269 Vilma Asuma Registered Nurse 1300 W 7th St, San Pedro, CA 90732-3505 2019-10-24
1932742905 Professional Anesthesia Associates PC Nurse Anesthetist, Certified Registered 1300 W 7th St, San Pedro, CA 90732-3505 2019-10-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538771241 Alicia Avila Student in an Organized Health Care Education/Training Program 2227 Blue Butterfly Way, #7, San Pedro, CA 90732 2020-08-24
1619500543 Udana Harris Registered Nurse 1300 West 7th Street, Obhc Unit, San Pedro, CA 90732 2020-02-19
1861042301 Patricia Elaine Moses Technician 106 N. Western Ave Unit 102, San Pedro, CA 90732 2019-09-17
1629627393 Antonio Ramon Martinez Technician 3141 Blue Butterfly Unit 66, San Pedro, CA 90732 2019-09-05
1487207700 Victoria A. Shook, D.d.s., A Professional Corp. Dentist 28138 S. Western Ave., San Pedro, CA 90732 2019-07-17
1144566563 Shaun E Chandran M D Inc Orthopaedic Surgery 1360 W 6th Street, Suite 305, San Pedro, CA 90732 2012-12-13
1316281280 Jenny Luong Physician Assistant 1534 W. 25th St, San Pedro, CA 90732 2012-11-16
1033429519 Eric M Feit Dpm Inc Podiatrist 1360 West 6th St., Suite 240, San Pedro, CA 90732 2010-10-18
1386808673 Meysam Zaker Dentist 2470 S. Western Ave, San Pedro, Ca, CA 90732 2008-07-15
1376735340 Francisco J. Correa, M.d., Inc General Practice 1350 W. 6th St, #3, San Pedro, CA 90732 2007-08-14
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Taxonomy Information

Taxonomy Code 273R00000X
Grouping Hospital Units
Classification Psychiatric Unit

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346264801 San Pedro Peninsula Hospital Psychiatric Unit 1300 W 7th St, San Pedro, CA 90732-3505 2006-07-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740807643 Pacific Health Group Inc. Psychiatric Unit 9120 Woodman Ave, Arleta, CA 91331-6405 2020-06-26
1720627979 Ernest Markovich Psychiatric Unit 3235 N Hartman St, Orange, CA 92865-1216 2020-01-04
1316416670 Psychiatric Excellence Psychiatric Unit 388 Market St Ste 1300, San Francisco, CA 94111-5316 2018-11-16
1982192514 Veronica E Martinez Psychiatric Unit 9481 Hanford St, Ventura, CA 93004-0704 2018-04-30
1679008817 Ucla Semel Institute Psychiatric Unit 615 6th St, Davis, CA 95616-3807 2017-04-25
1083152748 Rady Childrens Hospital-san Diego Psychiatric Unit 4305 University Avenue, Suite 150, San Diego, CA 92105 2017-02-02
1871045385 Molina Psychological Consultants Psychiatric Unit 18 Monrovia, Irvine, CA 92602-0925 2016-10-31
1457808073 Susan Mora Psychiatric Unit 1239 Powell St, Apt 2, San Francisco, CA 94133-4874 2016-09-01
1306204342 County of Santa Clara Psychiatric Unit 820 Enborg Court, San Jose, CA 95128 2016-02-05
1477931673 Nigthingale Nurses Psychiatric Unit 350 N Magnolia St, Woodlake, CA 93286-1320 2015-05-08
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Competitor

Search similar providers

City SAN PEDRO
Zip Code 90732

Improve Information

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Dataset Information

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.

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