MASONIC HOMES OF CALIFORNIA (NPI# 1578110524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578110524 |
| Entity Type | Organization |
| Organization Name | MASONIC HOMES OF CALIFORNIA |
| Practice Address |
1650 E Old Badillo St Covina CA 91724-3163 |
| Mailing Address |
1111 California St San Francisco CA 94108-2252 |
| Practice Telephone | 6262512200 |
| Mailing Telephone | 4152929166 |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-23 |
| Authorized Official Name | THOMAS BOYER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4152929166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639726102 | Masonic Homes of California | Skilled Nursing Facility | 161 S Reeder Ave, Covina, CA 91724-3129 | 2019-08-20 |
| 1295388106 | Masonic Homes of California | Community/Behavioral Health | 1650 E Old Badillo St, Covina, CA 91724-3163 | 2019-07-19 |
| 1043788953 | Masonic Homes of California | Psychiatry & Neurology | 6 Funston Ave, San Francisco, CA 94129-1109 | 2018-11-08 |
| 1114111317 | Masonic Homes of California | Community/Behavioral Health | 34400 Mission Blvd, Union City, CA 94587-3604 | 2007-08-30 |
| 1043426588 | Masonic Homes of California | Nursing Facility/Intermediate Care Facility | 34400 Mission Blvd, Union City, CA 94587-3604 | 2007-05-14 |
| 1639134950 | Masonic Homes of California | Pharmacy | 34400 Mission Blvd, Union City, CA 94587-3604 | 2006-04-19 |
| 1942293071 | Masonic Homes of California | Pharmacy | 34400 Mission Blvd, Union City, CA 94587-3604 | 2005-08-24 |
| Street Address |
1650 E OLD BADILLO ST |
| City | COVINA |
| State | CA |
| Zip Code | 91724-3163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295388106 | Masonic Homes of California | Community/Behavioral Health | 1650 E Old Badillo St, Covina, CA 91724-3163 | 2019-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902320922 | Kimberly Suzanne Manzanares-mora | Rehabilitation Practitioner | 1359 North Grand Avenue, Covina, CA 91724 | 2017-08-01 |
| 1689194680 | Cynthia Garcia | Counselor | 1359 N. Grand Ave., Covina, CA 91724 | 2017-06-21 |
| 1386191963 | West Covina Group Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 1274 Center Court Dr, #208, Covina, CA 91724 | 2016-09-01 |
| 1184094781 | Veronica May Roberts | Licensed Vocational Nurse | 222 S. Wilson Ave, Covina, CA 91724 | 2015-09-25 |
| 1912216292 | Joan Mendoza | Social Worker | 1338 Center Court Dr Ste 107, Covina, CA 91724 | 2010-10-04 |
| 1548583602 | Lille-anne Nzeribe | Rehabilitation Practitioner | 1126 N. Grand Ave. Suite D, Covina, CA 91724 | 2010-03-03 |
| 1154534212 | Verna L Lewis | Marriage & Family Therapist | 420 South Grand Ave., Covina, CA 91724 | 2007-05-07 |
| 1093937310 | Heather Annn Pedevillano | Specialist/Technologist | 1805 E. Lomira Dr, Covina, CA 91724 | 2007-05-03 |
| 1669503579 | Maritza Mercedes Reyes | Rehabilitation Practitioner | 1411 N. Grand Ave., Covina, CA 91724 | 2007-03-09 |
| 1417014085 | Bernadette Luyun Guaring Bagay | Dentist | 984 E Badillo St, Suite E, Covina, CA 91724 | 2007-01-03 |
| Find all providers in zip 91724 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710239462 | American Care Concept Corporation | Assisted Living Facility | 1073 E Knollcrest Dr, Covina, CA 91724-3431 | 2012-10-04 |
| 1669776548 | Arvassisted Living, Inc | Assisted Living Facility | 825 W San Bernardino Rd, Covina, CA 91722-3621 | 2011-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| 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.