PROVIDENCE SAINT JOHN'S HEALTH CENTER (NPI# 1679609648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679609648 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SAINT JOHN'S HEALTH CENTER |
| Other Organization Name | PROVIDENCE SAINT JOHNS HEALTH CDH |
| Practice Address |
1339 20th St Santa Monica CA 90404-2033 |
| Practice Telephone | 3108298921 |
| Practice Fax Number | 3108298455 |
| Mailing Telephone | 3108298921 |
| Mailing Fax Number | 3108298455 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2016-04-21 |
| Authorized Official Name | MRS. RUTH CANAS (OUTPATIENT DIRECTOR) |
| Authorized Official Telephone | 3108298921 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | Y |
| Parent Organization Name | SAINT JOHN'S HOSPITAL AND HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 569538 | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 000007169 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Saint Johns Health CDH | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184750168 | Providence Saint John's Health Center | Community/Behavioral Health | 1339 20th St, Santa Monica, CA 90404-2033 | 2007-02-26 |
| 1609901016 | Providence Saint John's Health Center | Community/Behavioral Health | 1339 20th St, Santa Monica, CA 90404-2033 | 2007-02-23 |
| 1124026273 | Providence Saint John's Health Center | General Acute Care Hospital | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2005-07-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE SAINT JOHN'S HEALTH CENTER | 1801 Lind Ave Sw, Department of Legal Affairs, Renton, WA 98057-3368 |
| Street Address |
1339 20TH ST |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90404-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912044736 | Francine Nicole Ortega | Social Worker | 1339 20th St, Santa Monica, CA 90404-2033 | 2007-01-31 |
| 1528671898 | Terri S Lee | Rehabilitation Practitioner | 1339 20th St, Santa Monica, CA 90404-2033 | 2020-08-26 |
| 1992322150 | Tamara Sakile Wulbrecht | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2020-07-02 |
| 1225655129 | Latisha Ayely Grigsby | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2020-06-26 |
| 1548814056 | Xavier Angel Fierro | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-08-01 |
| 1689235574 | Giovanni Ramos | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-06-22 |
| 1265091193 | Abbie J. Marsh | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-06-13 |
| 1245890102 | Tal Mazal Kempler | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-06-13 |
| 1932767035 | Agustina Bertone | Student in an Organized Health Care Education/Training Program | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-06-03 |
| 1053974899 | Abigail Pineda | Marriage & Family Therapist | 1339 20th St, Santa Monica, CA 90404-2033 | 2019-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453352 | Jasmine Burton | Physical Therapist | 1714 17th Street, Santa Monica, CA 90404 | 2020-09-24 |
| 1003431685 | Cintia Haydee Ctibor | Behavior Technician | 1869 9th Street, Santa Monica, CA 90404 | 2020-06-10 |
| 1073137261 | Sydney Kristine Valerio | Counselor | 1869 9th St, Santa Monica, CA 90404 | 2020-06-03 |
| 1710507082 | James Gilbert Cunningham | Marriage & Family Therapist | 1708 Olympic Blvd, Santa Monica, CA 90404 | 2020-04-16 |
| 1841763687 | Crystal Monique Mckinley X | Counselor | 1865 9th St, Santa Monica, CA 90404 | 2019-01-04 |
| 1952872749 | Cesar O Munoz | Licensed Vocational Nurse | 1865 9th St., Santa Monica, CA 90404 | 2018-12-06 |
| 1023596574 | Joseph J Pinzone Md Inc | Internal Medicine | 2001 Santa Monica Blvd Ste 1190, Santa Monica, CA 90404 | 2018-08-06 |
| 1548763535 | Alan Rubenstein Dds Inc | Dentist | 1260 15th St., #703, Santa Monica, CA 90404 | 2018-03-15 |
| 1669993382 | Aaron Wilson | Counselor | 1453 16th Street, Santa Monica, CA 90404 | 2017-07-03 |
| 1922472471 | Chianni Lin | Acupuncturist | 2222 Santa Monica Blvd, Ste. 105, Santa Monica, CA 90404 | 2015-11-20 |
| Find all providers in zip 90404 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801407945 | Behavioral Health Services, Inc. | Community/Behavioral Health | 1424 4th St Ste 205, Santa Monica, CA 90401-2352 | 2020-08-12 |
| 1144797697 | Vista Del Mar Child and Family Services | Community/Behavioral Health | 601 Pico Blvd. Ad 508-513, Santa Monica, CA 90405-1224 | 2018-11-01 |
| 1528507084 | Doctor Tlc, License Clinical Psychologist, Inc. | Community/Behavioral Health | 1242 Third St Promenade, Suite 208, Santa Monica, CA 90401 | 2017-02-16 |
| 1063878510 | Clare Matrix | Community/Behavioral Health | 1002 Pico Blvd, Santa Monica, CA 90405-1416 | 2016-01-13 |
| 1003159203 | Step By Step Edu-play | Community/Behavioral Health | 1412 14th St, Santa Monica, CA 90404-2704 | 2013-04-05 |
| 1912242413 | Early Start Preschools | Community/Behavioral Health | 2505 Lincoln Blvd, Santa Monica, CA 90405-3817 | 2012-12-10 |
| 1376800722 | The People Concern | Community/Behavioral Health | 1749 14th St, Santa Monica, CA 90404-4342 | 2012-04-23 |
| 1477829786 | Step-by-step Edu Play Programs | Community/Behavioral Health | 1814 14th St, 203, Santa Monica, CA 90404-7028 | 2012-03-30 |
| 1376811992 | The People Concern | Community/Behavioral Health | 503 Olympic Blvd, Santa Monica, CA 90401-3311 | 2011-12-09 |
| 1073804738 | Clare Matrix | Community/Behavioral Health | 1020 Pico Blvd, Santa Monica, CA 90405-1416 | 2011-04-28 |
| Find all providers in SANTA MONICA | ||||
| City | SANTA MONICA |
| Zip Code | 90404 |
Please comment or provide details below to improve the information on PROVIDENCE SAINT JOHN'S HEALTH CENTER.
| 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.