PASADENA VILLA, INC (NPI# 1720689755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720689755 |
| Entity Type | Organization |
| Organization Name | PASADENA VILLA, INC |
| Practice Address |
1811 N Raymond Ave Pasadena CA 91103-1840 |
| Practice Telephone | 3104138717 |
| Practice Fax Number | 8189276066 |
| Mailing Telephone | 3104138717 |
| Mailing Fax Number | 8189276066 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | KANDICE VERGARA WILLIAMS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3104138717 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Pasadena Villa Senior Living | Other Name - Individual/Organization |
| Street Address |
1811 N RAYMOND AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91103-1840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710178819 | Shirley Ann Bennett | Counselor | 1811 N Raymond Ave, Pasadena, CA 91103-1840 | 2007-08-05 |
| 1063608578 | Dalton Gudelmann | Counselor | 1811 N Raymond Ave, Pasadena, CA 91103-1840 | 2007-09-18 |
| 1639365141 | Robert Warren Burns Jr. | Counselor | 1811 N Raymond Ave, Pasadena, CA 91103-1840 | 2007-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1760906085 | Roberto Sotelo Jr. | Licensed Vocational Nurse | 867 North Fair Oaks Ave., Pasadena, CA 91103 | 2017-07-28 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1437671807 | Yolanda Centeno | Marriage & Family Therapist | 867 Fairoaks., Pasadena, CA 91103 | 2017-07-07 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922537372 | Chaznii Bradford | Licensed Vocational Nurse | 867 N. Fair Oaks, Pasadena, CA 91103 | 2017-06-08 |
| 1629505425 | Wassim Ammary | Pharmacist | 1855 South Fair Oaks Ave, Pasadena, CA 91103 | 2017-05-11 |
| 1679005920 | Grace Caroline Seto | Marriage & Family Therapist | 236 W. Mountain St, Suite 202d, Pasadena, CA 91103 | 2017-03-28 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| Find all providers in zip 91103 | ||||
| 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 |
|---|---|---|---|---|
| 1245852391 | The Park At Bay Area Limited Liability Company | Assisted Living Facility | 5000 Space Center Blvd, Pasadena, TX 77505-3966 | 2020-05-12 |
| 1952768988 | Pasadena Senior Living Center LLC | Assisted Living Facility | 1415 N Garfield Ave, Pasadena, CA 91104-2106 | 2016-01-21 |
| 1427415454 | Garfield Villas LLC | Assisted Living Facility | 1425 N Garfield Ave, Pasadena, CA 91104-2106 | 2016-01-21 |
| 1528425543 | Garfield Terrace LLC | Assisted Living Facility | 1435 N Garfield Ave, Pasadena, CA 91104-2106 | 2016-01-21 |
| 1568756922 | Bella Vista Retirement Home | Assisted Living Facility | 1760 N Fair Oaks Ave, Pasadena, CA 91103-1617 | 2011-06-02 |
| 1659525400 | Wonderful Time Adult Day Care and Activity Center | Assisted Living Facility | 1211 East Harris Ave., Pasadena, TX 77508-3619 | 2008-11-06 |
| 1144390311 | Pine Tree Assisted Living, L.p. | Assisted Living Facility | 5128 Pine Ave, Pasadena, TX 77503-3765 | 2006-11-08 |
| 1801448576 | The Pine Tree of Pasadena LLC | Assisted Living Facility | 2514 Pansy St, Pasadena, TX 77503-3926 | 2019-07-12 |
| 1003468281 | The Pine Tree of Pasadena LLC | Assisted Living Facility | 5128 Pine Ave, Pasadena, TX 77503-3765 | 2019-07-09 |
| 1134650385 | Pine Tree Acres | Assisted Living Facility | 5128 Pine Ave, Pasadena, TX 77503-3765 | 2017-03-21 |
| Find all providers in PASADENA | ||||
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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.