RADY CHILDREN'S HOSPITAL - SAN DIEGO (NPI# 1639387681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639387681 |
| Entity Type | Organization |
| Organization Name | RADY CHILDREN'S HOSPITAL - SAN DIEGO |
| Other Organization Name | DEVELOPMENTAL EVALUATION CLINIC |
| Practice Address |
3665 Kearny Villa Rd Suite 440 San Diego CA 92123-1953 |
| Mailing Address |
3020 Childrens Way Mc 5023 San Diego CA 92123-4223 |
| Practice Telephone | 8589661700 |
| Practice Fax Number | 8589667803 |
| Mailing Telephone | 8589661700 |
| Mailing Fax Number | 8589667803 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2017-04-03 |
| Authorized Official Name | MS. KATHLEEN CAIN (SR VICE PRESIDENT CHIEF FINANCIAL O) |
| Authorized Official Telephone | 8585761700 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | RADY CHILDREN'S HOSPITAL-SAN DIEGO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273R00000X | Psychiatric Unit | Hospital Units | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Developmental Evaluation Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245858992 | Rady Children's Hospital - San Diego | Occupational Therapist | 25170 Hancock Ave Ste 175, Murrieta, CA 92562-5969 | 2020-07-09 |
| 1649563065 | Rady Children's Hospital - San Diego | Psychologist | 11752 El Camino Real, Suite 100, San Diego, CA 92130-2050 | 2011-05-18 |
| 1720393176 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 2204 El Camino Real, Suite 102, Oceanside, CA 92054 | 2010-08-10 |
| 1114091055 | Rady Children's Hospital - San Diego | Skilled Nursing Facility | 3020 Childrens Way # Mc5019, San Diego, CA 92123-4223 | 2006-11-20 |
| 1780756411 | Rady Children's Hospital - San Diego | Nursing Facility/Intermediate Care Facility | 3453 Aveley Pl, San Diego, CA 92111-4727 | 2006-11-15 |
| 1053674564 | Rady Children's Hospital - San Diego | Psychiatric Unit | 3020 Childrens Way, San Diego, CA 92123-4223 | 2012-06-19 |
| 1639449994 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 3665 Kearny Villa Rd, Suite 405, San Diego, CA 92123-1953 | 2012-01-04 |
| 1154613818 | Rady Children's Hospital - San Diego | Psychologist | 3601 Vista Way, Suite 201, Oceanside, CA 92056-4559 | 2011-05-12 |
| 1457666802 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 333 H St, Suite 3010, Chula Vista, CA 91910-5555 | 2010-08-10 |
| 1699080051 | Rady Children's Hospital - San Diego | General Acute Care Hospital | 3665 Kearny Villa Rd, Suite 500, San Diego, CA 92123-1953 | 2010-08-10 |
| Street Address |
3665 KEARNY VILLA RD SUITE 440 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962508481 | Rady's Children's Hospital Outpatient Psychiatry San Diego | Marriage & Family Therapist | 3665 Kearny Villa Rd, 165, San Diego, CA 92123-1953 | 2006-09-15 |
| 1851952907 | Allison Rawls | Student in an Organized Health Care Education/Training Program | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2019-06-27 |
| 1578044012 | Neilson Chan | Student in an Organized Health Care Education/Training Program | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2018-08-23 |
| 1063907038 | Page Naomi Beukelman | Audiologist | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2018-06-22 |
| 1982119293 | Yesenia C Mejia | Psychologist | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2017-12-08 |
| 1104335835 | Stephanie Keffer | Speech-Language Pathologist | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2017-09-26 |
| 1740728179 | Natasha Proa | Case Manager/Care Coordinator | 3665 Kearny Villa Rd, Suite 165, San Diego, CA 92123-1953 | 2017-02-06 |
| 1194268425 | Kimberlee Ramirez | Speech-Language Pathologist | 3665 Kearny Villa Rd, Suite 300, San Diego, CA 92123-1953 | 2016-11-17 |
| 1073989380 | Brielle Williams | Speech-Language Pathologist | 3665 Kearny Villa Rd, Suite 300, San Diego, CA 92123 | 2015-08-20 |
| 1871969436 | Tara Jobin | Audiologist | 3665 Kearny Villa Rd, San Diego, CA 92123-1953 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184175374 | Kelly Lynn Memeo | General Acute Care Hospital | 8745 Aero Dr Ste 200, San Diego, CA 92123-1774 | 2016-10-22 |
| 1316392350 | Victor C. Coelho, Md, Inc. | General Acute Care Hospital | 2680 Bellezza Dr, San Diego, CA 92108-4763 | 2016-04-27 |
| 1144680695 | Reid Sasaki Md Inc | General Acute Care Hospital | 5663 Balboa Ave Unit 463, San Diego, CA 92111-2705 | 2016-02-25 |
| 1487028734 | Jfk Memorial Hospital | General Acute Care Hospital | 7717 Dancy Rd, San Diego, CA 92126-3040 | 2015-11-25 |
| 1124369632 | Brandon D Miller | General Acute Care Hospital | 2007 Pelican Hill Rd, San Diego, CA 92139-1152 | 2013-03-07 |
| 1992019020 | Catherine Ubaldo | General Acute Care Hospital | 2089 Chatsworth Blvd Apt 15, San Diego, CA 92107-2736 | 2010-07-30 |
| 1104143643 | Vision Medical Logistics | General Acute Care Hospital | 5555 Magnatron Blvd Ste I, San Diego, CA 92111-1308 | 2010-04-23 |
| 1891017729 | Uc San Diego Department of Anesthesiology | General Acute Care Hospital | 200 W Arbor Drive, #0801, Ucsd Dept of Anesthesiology, San Diego, CA 92103 | 2010-02-19 |
| 1275764292 | Ucsd Surgery | General Acute Care Hospital | 1240 India St Unit 914, San Diego, CA 92101-8551 | 2009-08-07 |
| 1982859138 | Cris Louise Rash | General Acute Care Hospital | 8811 Geraldine Ave, San Diego, CA 92123-2912 | 2008-12-01 |
| Find all providers in SAN DIEGO | ||||
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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.