ROSE MENDIOLA (NPI# 1417324872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417324872 |
| Entity Type | Individual |
| Full Name | ROSE MENDIOLA |
| Practice Address |
130 Stanford Dr Vallejo CA 94589-1746 |
| Practice Telephone | 7072467971 |
| Mailing Telephone | 7072467971 |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | R36801214 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | C0600029 | 05 |
| Street Address |
130 STANFORD DR |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-1746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023486586 | Anthonys Stithz | Substance Abuse Rehabilitation Facility | 2000 Ascot Pkwy, Vallejo, CA 94591-7009 | 2015-09-14 |
| 1043625346 | Locklind and Associates, LLC | Substance Abuse Rehabilitation Facility | 4749 Georgia St, Vallejo, CA 94591-6854 | 2014-06-25 |
| 1326352188 | House of Acts | Substance Abuse Rehabilitation Facility | 627 Grant St, Vallejo, CA 94590-7228 | 2010-08-03 |
| 1114127388 | Bi-bett | Substance Abuse Rehabilitation Facility | 126 Ohio St, Vallejo, CA 94590-5049 | 2007-07-24 |
| 1831265495 | Genesis House, Inc | Substance Abuse Rehabilitation Facility | 1149 Warren Ave, Vallejo, CA 94591-7512 | 2006-11-27 |
| 1275011637 | Sean Traynor | Substance Abuse Rehabilitation Facility | 251 Georgia St, Vallejo, CA 94590-5905 | 2018-07-29 |
| 1679019152 | Edna Marie White | Substance Abuse Rehabilitation Facility | 126 Ohio St, Vallejo, CA 94590-5049 | 2017-01-09 |
| 1629510557 | Jblockshin & Associates LLC | Substance Abuse Rehabilitation Facility | 4749 Georgia St, Vallejo, CA 94591-6854 | 2016-11-09 |
| 1922420298 | Shamia Recovery Center | Substance Abuse Rehabilitation Facility | 126 Ohio St, Vallejo, CA 94590-5049 | 2014-01-06 |
| 1326212051 | Bi-bett | Substance Abuse Rehabilitation Facility | 419 Pennsylvania St, Vallejo, CA 94590-6933 | 2008-04-14 |
| Find all providers in VALLEJO | ||||
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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.