ST. JUDE HOSPITAL YORBA LINDA (NPI# 1245777465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245777465 |
| Entity Type | Organization |
| Organization Name | ST. JUDE HOSPITAL YORBA LINDA |
| Other Organization Name | WELLNESS-ANAHEIM |
| Practice Address |
200 W Center Street Promenade Suite 100b Anaheim CA 92805-3960 |
| Practice Telephone | 7143477910 |
| Mailing Telephone | 7143477910 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Authorized Official Name | MR. JOHN BENNETT (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 7144494942 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Wellness-Anaheim | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306384375 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 3355 Michelson Dr, Suite 490, Irvine, CA 92612-0684 | 2017-02-09 |
| 1396283453 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 57 Prism, Irvine, CA 92618-3148 | 2017-02-08 |
| 1194263822 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 3701 Michelson St, Lakewood, CA 90712-1402 | 2017-02-01 |
| 1427596212 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 3345 Michelson Dr, Suite 350, Irvine, CA 92612-0692 | 2017-02-01 |
| 1306384185 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 4 Park Plz, Suite 150, Irvine, CA 92614-8560 | 2017-02-01 |
| 1932647716 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 600 Newport Center Dr, Suite 150, Newport Beach, CA 92660-6417 | 2017-02-01 |
| 1730627464 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 65 N 1st Ave, Suite 202c, Arcadia, CA 91006-3207 | 2017-02-01 |
| 1306383427 | St. Jude Hospital Yorba Linda | Non-Pharmacy Dispensing Site | 52 Discovery, Irvine, CA 92618-3105 | 2017-01-26 |
| Street Address |
200 W CENTER STREET PROMENADE SUITE 100B |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92805-3960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508230244 | Sandra Dawn Kazim | Nurse Practitioner | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2015-11-18 |
| 1699396655 | St. Joseph Health System Home Care Services | Pharmacy | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2020-04-30 |
| 1639715709 | St Joseph Heritage Healthcare | Family Medicine | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2019-11-22 |
| 1679133920 | Christa Marie Ellsworth | Pharmacist | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2019-06-19 |
| 1033654736 | St. Joseph Health Personal Care Services | In Home Supportive Care | 200 W Center Street Promenade, Suite 200, Anaheim, CA 92805-3960 | 2017-01-04 |
| 1447615414 | St. Joseph Health System Home Care Services | Home Health | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2015-12-17 |
| 1093189102 | St. Joseph Health Personal Care Services, LLC | Home Health | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2015-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841840097 | Jesus Jaime Rodriguez | Technician | 805 N. Pauline St., Anaheim, CA 92805 | 2019-09-18 |
| 1225680994 | Michael Cross | Counselor | 710 N. Anaheim Blvd Anaheim, Ca 92805, 710 N.anaheim Blvd, Anaheim, CA 92805 | 2019-07-12 |
| 1588123459 | Dania Jesri | Behavior Technician | 300 N Avelia Way, Anaheim, CA 92805 | 2019-03-19 |
| 1346708872 | Tiffany Chauvet | Behavior Technician | 1300 East Orangewood Ave, Anaheim, CA 92805 | 2019-03-04 |
| 1972087740 | Jehanzeb Shahab Khairi | Behavior Technician | 3101 E Orangewood Ave, Anaheim, CA 92805 | 2018-09-18 |
| 1033693825 | Baotran Minh Le | Behavior Technician | 3101 E. Orangewood Ave., Anaheim, CA 92805 | 2018-09-18 |
| 1841778354 | Jonathan Besuamlak | Behavior Technician | 1301 E. Orangewood Ave., Anaheim, CA 92805 | 2018-08-06 |
| 1700364973 | Erica Vanderlinden | Behavioral Analyst | 1301 East Orangewood Avenue, Anaheim, CA 92805 | 2018-07-31 |
| 1578054391 | Us Care Transportation LLC | Non-emergency Medical Transport (VAN) | 248 S Seneca Cir, Anaheim, CA 92805 | 2018-05-29 |
| 1578081691 | Christopher Mills | Counselor | 1025 S. Anaheim Blvd, Anaheim, CA 92805 | 2017-09-08 |
| Find all providers in zip 92805 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841616026 | Golden West Medical Corporation | Non-Pharmacy Dispensing Site | 1000 S. Anaheim Blvd., Suite 200, Anaheim, CA 92805-5802 | 2014-03-11 |
| 1497188742 | Angels Baseball Lp | Non-Pharmacy Dispensing Site | 2000 Gene Autry Way, Anaheim, CA 92806 | 2013-08-09 |
| 1093941692 | Lars Hanson Inc | Non-Pharmacy Dispensing Site | 145 S Chaparral Ct Ste And102, Anaheim, CA 92808-2265 | 2009-06-09 |
| 1821171158 | Keiichiro Omori Md | Non-Pharmacy Dispensing Site | 1801 W Romneya Dr Ste 407, Anaheim, CA 92801-1827 | 2006-10-23 |
| 1740534932 | Omar O. Fadeel, Md | Non-Pharmacy Dispensing Site | 3356 W Ball Rd, 100, Anaheim, CA 92804-3702 | 2012-11-09 |
| 1902159718 | Dennis Riff Md Inc Steven Duckor Prof Corp El Al | Non-Pharmacy Dispensing Site | 1211 W La Palma Ave, 306, Anaheim, CA 92801-2815 | 2012-10-17 |
| 1467711424 | Primary & Multi-specialty Clinics of Anaheim | Non-Pharmacy Dispensing Site | 500 S Anaheim Hills Rd, 230, Anaheim, CA 92807-4780 | 2012-05-11 |
| 1831456326 | Nicole Ann Garcia | Non-Pharmacy Dispensing Site | 6200 E Canyon Rim Rd, Suite 105b, Anaheim, CA 92807-4317 | 2012-04-20 |
| 1184996423 | Southern California Electrophysiology Associates | Non-Pharmacy Dispensing Site | 1211 W La Palma Ave, 408, Anaheim, CA 92801-2815 | 2012-02-02 |
| 1578878252 | Orange County Medical Group, Inc | Non-Pharmacy Dispensing Site | 1211 W La Palma Ave, Ste 709, Anaheim, CA 92801-2815 | 2010-08-18 |
| Find all providers in ANAHEIM | ||||
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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.