CENTRAL VALLEY SPECIALTY HOSPITAL INC (NPI# 1356693451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356693451 |
| Entity Type | Organization |
| Organization Name | CENTRAL VALLEY SPECIALTY HOSPITAL INC |
| Other Organization Name | CENTRAL VALLEY SPECIALTY HOSPITAL SKILLED NURSING FACILITY |
| Practice Address |
730 17th St Modesto CA 95354-1209 |
| Mailing Address |
1320 Standiford Ave Suite 4 Pmb 214 Modesto CA 95350-0726 |
| Practice Telephone | 2092487710 |
| Practice Fax Number | 2098460345 |
| Mailing Telephone | 2095762532 |
| Mailing Fax Number | 2095762598 |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | TAMMY JEAN THOMPSON (VP FINANCE) |
| Authorized Official Telephone | 2092487851 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL VALLEY SPECIALTY HOSPITAL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | CA0301202 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 55-5882 | 05 |
| Other Name | Type Code |
|---|---|
| Central Valley Specialty Hospital Skilled Nursing Facility | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427520998 | Central Valley Specialty Hospital Inc | Long Term Care Hospital | 730 17th St, Modesto, CA 95354-1209 | 2018-12-21 |
| 1578989703 | Central Valley Specialty Hospital Inc | Long Term Care Hospital | 730 17th St, Modesto, CA 95354-1209 | 2014-03-12 |
| Street Address |
730 17TH ST |
| City | MODESTO |
| State | CA |
| Zip Code | 95354-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205811726 | Danny Vera | Pharmacist | 730 17th St, Modesto, CA 95354-1209 | 2005-12-07 |
| 1609490291 | David Borofka | Respiratory Therapist, Certified | 730 17th St, Modesto, CA 95354-1209 | 2020-05-30 |
| 1982236303 | Calvin P Truong | Pharmacist | 730 17th St, Modesto, CA 95354-1209 | 2020-02-05 |
| 1427520998 | Central Valley Specialty Hospital Inc | Long Term Care Hospital | 730 17th St, Modesto, CA 95354-1209 | 2018-12-21 |
| 1508341108 | Pamela Carter | Physical Therapist | 730 17th St, Modesto, CA 95354-1209 | 2018-09-28 |
| 1588040299 | Dave Cortes Dy | Nurse Practitioner | 730 17th St, Modesto, CA 95354-1209 | 2015-08-04 |
| 1518343649 | Karenjit Johal | Dietitian, Registered | 730 17th St, Modesto, CA 95354-1209 | 2015-07-30 |
| 1578989703 | Central Valley Specialty Hospital Inc | Long Term Care Hospital | 730 17th St, Modesto, CA 95354-1209 | 2014-03-12 |
| 1154766921 | Om Medical Inc | Internal Medicine | 730 17th St, Modesto, CA 95354-1209 | 2013-05-07 |
| 1134470156 | Central Valley Specialty Hospital, Inc. | General Acute Care Hospital | 730 17th St, Modesto, CA 95354-1209 | 2012-10-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669987301 | Tristan Renee Bowman | Student in an Organized Health Care Education/Training Program | 1700 Mchenry Way, Modesto, CA 95354 | 2017-12-04 |
| 1134647944 | Melissa Kathleen Huizar | Occupational Therapist | 730 17th Street, Modesto, CA 95354 | 2017-08-31 |
| 1861948424 | Daniel Jones | Specialist/Technologist | 224 Eula Drive, Modesto, CA 95354 | 2016-09-01 |
| 1710333976 | Elite First Health | Clinic/Center | 3121 Yosemite Blvd Ste D2, Modesto, CA 95354 | 2016-05-06 |
| 1790169084 | Ronika Rodriguez | Licensed Vocational Nurse | 328 Thrasher Ave, Modesto, CA 95354 | 2015-07-16 |
| 1942688528 | Progressive Home Health and Hospice Care, LLC | Home Infusion | 1619 H Street, Modesto, CA 95354 | 2015-05-14 |
| 1225434277 | Ashley Ann Brown | Case Manager/Care Coordinator | 1000 Needham, Modesto, CA 95354 | 2014-11-18 |
| 1922380518 | Thao Truong | Specialist | 1321 I St Ste #3, Modesto, CA 95354 | 2011-09-09 |
| 1437441938 | Amy Marie Lipomi | Counselor | 613 13th Street, Suite B, Modesto, CA 95354 | 2011-05-03 |
| 1871800813 | Patricia Ashley Dalman | Social Worker | 1321 I Street Suite 3, Modesto, CA 95354 | 2010-09-13 |
| Find all providers in zip 95354 | ||||
| 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 |
|---|---|---|---|---|
| 1437291929 | Covenant Care California, LLC | Skilled Nursing Facility | 3620 Dale Rd, Suite B, Modesto, CA 95356-0598 | 2007-02-13 |
| 1932251808 | Cf Modesto, LLC | Skilled Nursing Facility | 159 East Orangeburg Avenue, Modesto, CA 95350 | 2007-01-18 |
| 1427110055 | Sky Park Health Care Inc. | Skilled Nursing Facility | 1611 Scenic Dr, Modesto, CA 95355-4907 | 2006-12-13 |
| 1033221999 | Yosemite Convalescent Hospital, Inc. | Skilled Nursing Facility | 159 E Orangeburg Ave, Modesto, CA 95350-5334 | 2006-08-31 |
| 1508884487 | Crestwood Behavioral Health, Inc. | Skilled Nursing Facility | 1400 Celeste Dr, Modesto, CA 95355-5041 | 2006-07-18 |
| 1801832464 | Fig Holdings, LLC | Skilled Nursing Facility | 1310 W Granger Ave, Modesto, CA 95350-3911 | 2006-06-21 |
| 1487641361 | Covenant Care California Inc | Skilled Nursing Facility | 3620b Dale Rd, Modesto, CA 95356-0500 | 2005-10-05 |
| 1851385843 | Avalon Care Center - Modesto Hylond, LLC | Skilled Nursing Facility | 1900 Coffee Rd, Modesto, CA 95355-2703 | 2005-09-06 |
| 1245237965 | Evergreen Convalescent Hospital and Rehabilitation Center, Inc. | Skilled Nursing Facility | 2030 Evergreen Ave, Modesto, CA 95350-3785 | 2005-07-07 |
| 1154325512 | Ghc of Modesto, LLC | Skilled Nursing Facility | 2633 W Rumble Rd, Modesto, CA 95350-0154 | 2005-06-13 |
| Find all providers in MODESTO | ||||
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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.