COVENANT CARE CALIFORNIA, LLC (NPI# 1528100013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528100013 |
| Entity Type | Organization |
| Organization Name | COVENANT CARE CALIFORNIA, LLC |
| Other Organization Name | PACIFIC GARDENS NURSING & REHABILITATION CENTER |
| Practice Address |
577 South Peach Avenue Fresno CA 93727-3952 |
| Practice Telephone | 5592518463 |
| Practice Fax Number | 5592514465 |
| Mailing Telephone | 5592518463 |
| Mailing Fax Number | 5592514465 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-02-03 |
| Authorized Official Name | CAROL SPARKS (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9493491200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 040000130 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OSHPD | 206100772 | 01 |
| CA | ZZR06207J | 05 |
| Other Name | Type Code |
|---|---|
| Pacific Gardens Nursing & Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780719278 | Covenant Care California, LLC | Skilled Nursing Facility | 911 Bryant Street, Palo Alto, CA 94301-2711 | 2007-02-23 |
| 1043345812 | Covenant Care California, LLC | Skilled Nursing Facility | 809 Fremont Avenue, Los Altos, CA 94024-5617 | 2007-02-22 |
| 1437291929 | Covenant Care California, LLC | Skilled Nursing Facility | 3620 Dale Rd, Suite B, Modesto, CA 95356-0598 | 2007-02-13 |
| 1346382298 | Covenant Care California, LLC | Skilled Nursing Facility | 2124 57th Avenue, Oakland, CA 94621-4322 | 2007-02-13 |
| 1134261142 | Covenant Care California, LLC | Skilled Nursing Facility | 6821 24th Street, Sacramento, CA 95822-4037 | 2007-02-13 |
| 1831231877 | Covenant Care California, LLC | Skilled Nursing Facility | 8170 Murray Avenue, Gilroy, CA 95020-4605 | 2007-02-13 |
| 1053453902 | Covenant Care California, LLC | Skilled Nursing Facility | 2725 Pacific Avenue, Long Beach, CA 90806-2612 | 2007-02-13 |
| 1801938816 | Covenant Care California, LLC | Skilled Nursing Facility | 9289 Branstetter Place, Stockton, CA 95209-1700 | 2007-02-13 |
| 1164563276 | Covenant Care California, LLC | Skilled Nursing Facility | 1111 E. Tuolumne Road, Turlock, CA 95382-1541 | 2007-02-09 |
| 1205977311 | Covenant Care California, LLC | Skilled Nursing Facility | 160 S Patterson Avenue, Santa Barbara, CA 93111-2006 | 2007-02-09 |
| Street Address |
577 SOUTH PEACH AVENUE |
| City | FRESNO |
| State | CA |
| Zip Code | 93727-3952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427524354 | Travis L Minor | Driver | 4573 Kings Canyon Rd, Freso, CA 93727 | 2018-10-18 |
| 1780178921 | Amanda Hernandez | Behavior Technician | 6358 E Mono St, Fresno, CA 93727 | 2018-06-20 |
| 1225533169 | Lindsay Fisher | Marriage & Family Therapist | 4928 E Clinton Way Ste 108, Fresno, CA 93727 | 2018-03-23 |
| 1811351992 | Paulinder Ranu | Pediatrics | 5557 E King Cyn Rd, Fresno, CA 93727 | 2016-04-05 |
| 1851781371 | Sheri Taylor | Social Worker | 2010 N Fine Ave # 105, Fresno, CA 93727 | 2015-02-04 |
| 1770917486 | Elouise Jones-green | Counselor | 4491 E. Mckinley Ave #112, Fresno, CA 93727 | 2013-08-29 |
| 1700227022 | Chee Vang | Counselor | 4855 E Kings Canyon Rd Ste 105, Fresno, CA 93727 | 2013-07-15 |
| 1578839791 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5995 E Kings Canyon Rd, Fresno, CA 93727 | 2012-04-02 |
| 1932411378 | Leticia Ball | Marriage & Family Therapist | 4944 E. Clinton Way, Fresno, CA 93727 | 2010-07-13 |
| 1639308158 | Juanita Sermeno | Counselor | 4944 E. Clinton, Suite 101, Fresno, CA 93727 | 2009-07-06 |
| Find all providers in zip 93727 | ||||
| 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 |
|---|---|---|---|---|
| 1598308850 | Acme Care, Inc | Skilled Nursing Facility | 6253 N Colonial Ave, Fresno, CA 93704-1437 | 2019-10-18 |
| 1245779305 | Senior Med Care Living Inc | Skilled Nursing Facility | 2275 N Saratoga Ave, Fresno, CA 93722-4696 | 2017-02-21 |
| 1952766693 | Fresno Postacute Care LLC | Skilled Nursing Facility | 1233 A St., Fresno, CA 93706-3202 | 2015-12-23 |
| 1548625718 | Northern California Congregate Living, Inc | Skilled Nursing Facility | 5321 W Roberts Ave, Fresno, CA 93722-7737 | 2015-12-15 |
| 1306213517 | Babujyan Healthcare, Inc. | Skilled Nursing Facility | 1419 W Bullard Ave, Fresno, CA 93711-2324 | 2015-08-24 |
| 1346623378 | Mehdi Hakimipour Md, Inc. | Skilled Nursing Facility | 315 E Nees Ave, #124, Fresno, CA 93720-2062 | 2015-07-08 |
| 1720499908 | Affinity Congregate Living, Inc | Skilled Nursing Facility | 3150 E Shields Ave, Fresno, CA 93726-6901 | 2014-05-10 |
| 1134480817 | Humangood Fresno | Skilled Nursing Facility | 5551 N Fresno St, Fresno, CA 93710 | 2012-05-30 |
| 1336287077 | Manning Gardens Care Center Inc | Skilled Nursing Facility | 2113 E Manning Ave, Fresno, CA 93725-9681 | 2007-02-02 |
| 1851438634 | Caremeridian, LLC | Skilled Nursing Facility | 6385 N Marks Ave, Fresno, CA 93711-1652 | 2007-01-31 |
| Find all providers in FRESNO | ||||
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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.