ST JUDE HOSPITAL YORBA LINDA (NPI# 1467758839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467758839 |
Entity Type | Organization |
Organization Name | ST JUDE HOSPITAL YORBA LINDA |
Other Organization Name | ST JOSEPH HERITAGE HEALTHCARE |
Practice Address |
100 E Valencia Mesa Dr Suite 310 Fullerton CA 92835-3813 |
Mailing Address |
279 Imperial Hwy Suite 730 Fullerton CA 92835-1041 |
Practice Telephone | 7144465200 |
Practice Fax Number | 7144465524 |
Mailing Telephone | 7144494841 |
Mailing Fax Number | 7144494956 |
Enumeration Date | 2011-02-02 |
Last Update Date | 2011-02-02 |
Authorized Official Name | JOHN BENNETT (CHIEF OPERATING OFFICER) |
Authorized Official Telephone | 7144494800 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
ST JOSEPH HERITAGE HEALTHCARE | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801254594 | St Jude Hospital Yorba Linda | Emergency Medicine | 925 Corporate Cntr Pkwy, Suite A, Santa Rosa, CA 95407-5451 | 2016-02-09 |
1780980169 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 24 W El Rose Dr, Petaluma, CA 94952-4023 | 2011-02-02 |
1043608805 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 | 2015-01-02 |
1831587955 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 108 Lynch Creek Way, Suite 3, Petaluma, CA 94954-2357 | 2014-12-23 |
1376963314 | St Jude Hospital Yorba Linda | Internal Medicine | 3555 Round Barn Cir, Santa Rosa, CA 95403-1757 | 2014-04-17 |
1700214913 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2141 N Harbor Blvd, Suite 25000, Fullerton, CA 92835-3827 | 2013-10-25 |
1053617076 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 4750 Hoen Ave, Santa Rosa, CA 95405-7833 | 2011-02-09 |
1942506969 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 4900 Prospect Ave, Suite 180, Yorba Linda, CA 92886-2128 | 2011-02-09 |
1679879696 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2720 N Harbor Blvd, Suite 200, Fullerton, CA 92835-2609 | 2011-02-09 |
1588960504 | St Jude Hospital Yorba Linda | Durable Medical Equipment & Medical Supplies | 2720 N Harbor Blvd, Suite 220, Fullerton, CA 92835-2609 | 2011-02-09 |
Street Address |
100 E VALENCIA MESA DR SUITE 310 |
City | FULLERTON |
State | CA |
Zip Code | 92835-3813 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891795449 | Raed Ali | Orthopaedic Surgery | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3813 | 2005-07-26 |
1083088678 | Monica Martyn | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2015-11-19 |
1972991149 | Megan Somerville Wroe | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-12-22 |
1457750762 | Linda Cox | Registered Nurse | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-08-22 |
1952700320 | Cynthia Crystal Carrasco-gonzalez | Registered Nurse | 100 E Valencia Mesa Dr, Suite 111, Fullerton, CA 92835-3813 | 2014-08-21 |
1548697311 | Theodore Pastrana Md., Apc | Preferred Provider Organization | 100 E Valencia Mesa Dr, Ste. 100, Fullerton, CA 92835-3813 | 2013-10-10 |
1831526953 | Kathryn V Woeckener | Dietitian, Registered | 100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813 | 2013-10-03 |
1588001267 | Ricarda Benz Md, Inc | Obstetrics & Gynecology | 100 E Valencia Mesa Dr, Suite 215, Fullerton, CA 92835-3813 | 2013-06-04 |
1518302777 | Gordon Gunn M.d Inc A Medical Corporation | Specialist | 100 E Valencia Mesa Dr, # 215, Fullerton, CA 92835-3813 | 2013-05-01 |
1770831521 | Aileen Sabio Estrada | Physician Assistant | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3813 | 2012-08-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538774302 | Natalie Baugh | Nutritionist | 333 W Bastanchury Rd 110, Fullerton, CA 92835 | 2020-09-09 |
1073127098 | Cecile Mae Sam | Physical Therapist | 2932 Clover Ct, Fullerton, CA 92835 | 2020-09-08 |
1861966087 | Kimson F Johnston | Marriage & Family Therapist | 1370 Brea Blvd Suite 210, Fullerton, CA 92835 | 2019-01-22 |
1134636327 | Michelle Harriman, Psychologist - A Professional Corporation | Psychologist | 1440 N Harbor Blvd Ste 808, Fullerton, CA 92835 | 2018-01-09 |
1659818631 | Jacqueline Rene Miller | Specialist/Technologist | 2610 Associated Rd, Apt A4, Fullerton, CA 92835 | 2017-01-27 |
1912361106 | John Nathaniel Alvarez | Psychiatry & Neurology | 401 E Imperial Highway, Fullerton, CA 92835 | 2016-04-13 |
1083075030 | Advance Recovery Solution, LLC | Substance Abuse Rehabilitation Facility | 3744 N Hermosa Pl, Fullerton, CA 92835 | 2016-03-17 |
1467817981 | Michele Ledesma | Physical Therapy Assistant | 2800 N. Harbor Blvd., Fullerton, CA 92835 | 2015-12-29 |
1467820571 | Jonghan Kang | Acupuncturist | 1321 N Harbor Blvd Ste 205, Fullerton, CA 92835 | 2015-09-04 |
1265840987 | Allison Leigh Kennedy | Physician Assistant | 100 Laguna Rd Ste 208, Fullerton, CA 92835 | 2014-07-25 |
Find all providers in zip 92835 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275579195 | Regional Pain Treatment Medical Center Inc | Pain Medicine | 295 Imperial Hwy, Suite 100, Fullerton, CA 92835-1020 | 2006-06-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538795836 | John Qian M.d. Inc. | Pain Medicine | 5360 Jackson Dr Ste 100, La Mesa, CA 91942-3012 | 2020-03-18 |
1831751403 | Abigail Howe | Pain Medicine | 2421 Park Blvd # B205, Palo Alto, CA 94306-1998 | 2019-07-03 |
1144781519 | Central Coast Functional Restoration Program Inc | Pain Medicine | 1260 41st Ave Ste D, Capitola, CA 95010-3929 | 2019-03-28 |
1497226419 | Birladeanu Medical Corp | Pain Medicine | 5255 Elkhorn Blvd Ste A, Sacramento, CA 95842-2506 | 2018-12-17 |
1033649413 | Latora Subani | Pain Medicine | 16179 Siskiyou Rd, Apple Valley, CA 92307-1314 | 2017-06-18 |
1982061354 | Hilary J Fausett, M.d. A Medical Corporation | Pain Medicine | 39 Congress St Ste 303, Pasadena, CA 91105-3022 | 2016-01-15 |
1346616695 | Nuvation Pain Group | Pain Medicine | 5832 Beach Blvd Unit 208, Buena Park, CA 90621-5501 | 2015-08-20 |
1740674050 | Guardian Headache and Pain Management Institute LLC | Pain Medicine | 3747 Franklin Ave, Suite 200, Long Beach, CA 90808-1334 | 2015-03-25 |
1659764397 | Integrated Pain Treatment Center | Pain Medicine | 4312 Feather River Drive, Suite C, Stockton, CA 95219 | 2015-03-05 |
1659772606 | Sonny Rubin, M.d. Inc | Pain Medicine | 455 Old Newport Blvd, Suite 101, Newport Beach, CA 92663-4241 | 2014-09-09 |
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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.