GORDON LANE HEALTHCARE LLC (NPI# 1205932126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205932126 |
| Entity Type | Organization |
| Organization Name | GORDON LANE HEALTHCARE LLC |
| Other Organization Name | GORDON LANE CARE CENTER |
| Practice Address |
1821 E Chapman Ave Fullerton CA 92831-4102 |
| Mailing Address |
3050 Saturn St Ste 201 Brea CA 92821-6221 |
| Practice Telephone | 7148797301 |
| Practice Fax Number | 7142243320 |
| Mailing Telephone | 7145773880 |
| Mailing Fax Number | 7145773892 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2015-06-03 |
| Authorized Official Name | MRS. JEANNE M NELSON (AR MANAGER) |
| Authorized Official Telephone | 7145773880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 060000118 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC55797F | 05 |
| Other Name | Type Code |
|---|---|
| Gordon Lane Care Center | Doing Business As Name - Organization |
| Street Address |
1821 E CHAPMAN AVE |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-4102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922464098 | Patricia Marice Virata | Occupational Therapy Assistant | 1821 E Chapman Ave, Fullerton, CA 92831-4102 | 2016-01-05 |
| 1063886794 | So Young Choi | Occupational Therapist | 1821 E Chapman Ave, Fullerton, CA 92831 | 2015-11-18 |
| 1801285309 | Mary Anne Walker | Occupational Therapist | 1821 E Chapman Ave, Fullerton, CA 92831 | 2015-01-21 |
| 1194113886 | Jeffrey Villaflores | Physical Therapy Assistant | 1821 E Chapman Ave, Fullerton, CA 92831-4102 | 2015-01-02 |
| 1003108036 | Ronaldo Cabrera | Physical Therapist | 1821 E Chapman Ave, Fullerton, CA 92831-4102 | 2011-05-10 |
| 1699074377 | Pooja Shah | Occupational Therapist | 1821 E Chapman Ave, Fullerton, CA 92831-4102 | 2011-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| 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 |
|---|---|---|---|---|
| 1578656427 | Windsor Gardens Healthcare Center of Fullerton, LLC | Skilled Nursing Facility | 245 E Wilshire Ave, Fullerton, CA 92832-1935 | 2006-10-02 |
| 1225089527 | Ggnsc Fullerton LLC | Skilled Nursing Facility | 202 N Esther St, Fullerton, NE 68638-3029 | 2006-05-12 |
| 1104874239 | Evergreen At Fullerton, L.L.C. | Skilled Nursing Facility | 2222 N Harbor Blvd, Fullerton, CA 92835-2605 | 2006-05-04 |
| 1396718813 | St. Elizabeth Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 2800 N Harbor Blvd, Fullerton, CA 92835-1727 | 2006-02-08 |
| 1740265248 | Sun Haven Care, Inc. | Skilled Nursing Facility | 210 E Bastanchury Rd, Fullerton, CA 92835-2607 | 2005-12-07 |
| 1871580480 | Greenfield Care Center of Fullerton, LLC | Skilled Nursing Facility | 330 W Bastanchury Rd, Fullerton, CA 92835-3403 | 2005-09-29 |
| 1205445848 | Santa Catalina Healthcare, Inc. | Skilled Nursing Facility | 245 E Wilshire Ave, Fullerton, CA 92832-1935 | 2020-07-29 |
| 1861954935 | Fullerton Operations LLC | Skilled Nursing Facility | 202 N Esther St, Fullerton, NE 68638-3029 | 2019-04-05 |
| 1285198192 | Fullerton Healthcare, Inc. | Skilled Nursing Facility | 2800 N Harbor Blvd, Fullerton, CA 92835-1727 | 2019-01-24 |
| 1730535378 | Sarah Huber | Skilled Nursing Facility | 245 E Wilshire Ave, Fullerton, CA 92832-1935 | 2016-05-12 |
| Find all providers in FULLERTON | ||||
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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.