VERICARE OF CALIFORNIA MEDICAL GROUP (NPI# 1316992829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316992829 |
| Entity Type | Organization |
| Organization Name | VERICARE OF CALIFORNIA MEDICAL GROUP |
| Other Organization Name | VERICARE |
| Practice Address |
1633 Cypress Ln Paradise CA 95969-2823 |
| Mailing Address |
55 Hatchetts Hill Rd Old Lyme CT 06371-1534 |
| Practice Telephone | 8002578715 |
| Practice Fax Number | 8008191655 |
| Mailing Telephone | 8003703651 |
| Mailing Fax Number | 8775157147 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-07-10 |
| NPI Deactivation Date | 04/11/2007 |
| NPI Reactivation Date | 2007-08-08 |
| Authorized Official Name | MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT) |
| Authorized Official Telephone | 8003703651 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CC7816 | 01 |
| CA | GPS000150 | 05 |
| Other Name | Type Code |
|---|---|
| Vericare | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538114053 | Vericare of California Medical Group | Social Worker | 325 Kempton St, Spring Valley, CA 91977-5810 | 2006-05-23 |
| 1275588790 | Vericare of California Medical Group | Social Worker | 1835 W La Veta Ave, Orange, CA 92868-4132 | 2006-05-23 |
| 1164475299 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-18 |
| 1528011764 | Vericare of California Medical Group | Social Worker | 81 Professional Ctr Pkwy, San Rafael, CA 94903-2797 | 2006-05-18 |
| 1407047673 | Vericare of California Medical Group | Nurse Practitioner | 3293 N Drinkwater Blvd, Scottsdale, AZ 85251-6405 | 2007-08-05 |
| 1689629198 | Vericare of California Medical Group | Social Worker | 205 Granada St, Camarillo, CA 93010-7715 | 2006-05-23 |
| 1760437271 | Vericare of California Medical Group | Social Worker | 1505 Colby Dr, Glendale, CA 91205-3307 | 2006-05-23 |
| 1194779439 | Vericare of California Medical Group | Social Worker | 2501 Alvin Ave, San Jose, CA 95121-1660 | 2006-05-20 |
| 1104879980 | Vericare of California Medical Group | Social Worker | 2707 Pine St, San Francisco, CA 94115-2522 | 2006-05-19 |
| 1942254644 | Vericare of California Medical Group | Social Worker | 430 Willow St, Alameda, CA 94501-6130 | 2006-05-19 |
| Street Address |
1633 CYPRESS LN |
| City | PARADISE |
| State | CA |
| Zip Code | 95969-2823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720457492 | Maqui Holdings, LLC | Skilled Nursing Facility | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2015-09-23 |
| 1639415458 | Jeffrey Robert Tyler | Occupational Therapist | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2012-12-26 |
| 1831481845 | Elizabeth Tate Pearson | Occupational Therapist | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2011-05-09 |
| 1811161300 | Patricia Keeney | Physical Therapy Assistant | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2008-04-16 |
| 1306028527 | Lifehouse Cypress Operations, LLC | Skilled Nursing Facility | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2007-11-29 |
| 1033131966 | Ember Care Corporation | Skilled Nursing Facility | 1633 Cypress Ln, Paradise, CA 95969-2823 | 2006-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699234559 | Skala Chiropractic Inc | Chiropractor | 4413 Sierra Del Sol, Paradise, CA 95969 | 2019-03-19 |
| 1114463924 | Gary R Watts | Obstetrics & Gynecology | 5016 Lago Vista Way, Paradise, CA 95969 | 2017-01-18 |
| 1013367044 | Leslie Allison Bass | Registered Nurse | 1309 Nunneley Road, Paradise, CA 95969 | 2016-06-21 |
| 1457798977 | Lisa Marie Nelson | Counselor | 5910 Clark Road Suite 179, Paradise, CA 95969 | 2013-05-23 |
| 1700121597 | Ann Mary Sullivan | Marriage & Family Therapist | 955 Elliott Road, Paradise, CA 95969 | 2012-12-05 |
| 1255631693 | Paola Maria Mccarthy | Pharmacist | 6020 Clark Rd, Paradise, CA 95969 | 2010-11-02 |
| 1871821678 | Lisa Alison Franco | Occupational Therapist | 1633 Cypress Ln., Lifehouse/cypress, Paradise, CA 95969 | 2009-12-07 |
| 1700017548 | Michael C Reilly | Occupational Therapy Assistant | 1633 Cypress Lane, Paradise, CA 95969 | 2009-07-28 |
| 1992985899 | James D Salomone | Counselor | 7690 East Rd, Redwood Valley, CA 95969 | 2007-11-07 |
| 1548461619 | Paradise Ultrasound | Radiologic Technologist | 5921 Clark Rd, Ste. C, Paradise, CA 95969 | 2007-05-29 |
| Find all providers in zip 95969 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780764225 | Robert Dick Barram | Psychologist | 5800 Acorn Ridge Dr, Paradise, CA 95969-3754 | 2006-10-17 |
| 1083892954 | Jennifer Weesner | Psychologist | 6076 Pentz Rd, Paradise, CA 95969-5541 | 2008-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
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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.