STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES (NPI# 1730130071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730130071 |
| Entity Type | Organization |
| Organization Name | STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES |
| Other Organization Name | AGNEWS DEVELOPMENTAL CENTER |
| Practice Address |
3500 Zanker Rd San Jose CA 95134-2201 |
| Mailing Address |
Po Box 944202 1600 9th Street Sacramento CA 94244-2020 |
| Practice Telephone | 4084516198 |
| Practice Fax Number | 4084516167 |
| Mailing Telephone | 9166542431 |
| Mailing Fax Number | 9166543186 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2009-01-06 |
| Authorized Official Name | MS. KATHY KINSER (DEPUTY DIRECTOR) |
| Authorized Official Telephone | 9166541963 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | 160000519 | CA | Hospitals |
| N | 314000000X | Skilled Nursing Facility | 160000519 | CA | Nursing & Custodial Care Facilities |
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | 160000519 | CA | Nursing & Custodial Care Facilities |
| N | 333600000X | Pharmacy | 160000519 | CA | Suppliers |
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 160000519 | CA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Agnews Developmental Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730130097 | State of California - Department of Developmental Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69696 Ramon Rd, Cathedral City, CA 92234-3353 | 2006-05-12 |
| 1841241130 | State of California - Department of Developmental Services | Nursing Facility/Intermediate Care Facility | 1251 Stabler Ln, Yuba City, CA 95993-2616 | 2006-05-12 |
| 1225089592 | State of California - Department of Developmental Services | Long Term Care Hospital | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2006-05-12 |
| 1588615835 | State of California - Department of Developmental Services | Long Term Care Hospital | 26501 Avenue 140, Porterville, CA 93257-9109 | 2006-05-12 |
| 1154372498 | State of California - Department of Developmental Services | Nursing Facility/Intermediate Care Facility | 3530 Pomona Blvd, Pomona, CA 91768-3238 | 2006-05-12 |
| 1093085565 | State of California - Department of Developmental Services | Clinic/Center | 3530 W Pomona Blvd, Pomona, CA 91768-3238 | 2011-12-30 |
| 1982990206 | State of California - Department of Developmental Services | Intermediate Care Facility, Mentally Retarded | 26501 Avenue 140, Porterville, CA 93257-9109 | 2011-06-24 |
| 1851344220 | State of California - Department of Developmental Services | Long Term Care Hospital | 15000 Arnold Drive, Eldridge, CA 95431-1493 | 2006-05-18 |
| Street Address |
3500 ZANKER RD |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95134-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255579363 | Gerri Lane Armstrong-walker | Psychologist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2009-01-27 |
| 1760644165 | Kelly Mitchell-headley | Occupational Therapist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2008-06-26 |
| 1710148515 | Agnews Community Clinic | Clinic/Center | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2008-06-24 |
| 1396958849 | Susan Dorcas Smithson | Physical Therapist | 3500 Zanker Rd, San Jose, CA 95134-2299 | 2007-05-08 |
| 1942303920 | John Richard Faull | Psychologist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2006-09-06 |
| 1972519601 | David J Barclay | Occupational Therapist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2006-08-01 |
| 1285649152 | Renee Patrice New | Occupational Therapist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2006-07-29 |
| 1982619847 | Linda Patricia Kite | Physical Therapist | 3500 Zanker Rd, San Jose, CA 95134-2201 | 2006-07-29 |
| 1689610933 | John Kenneth Darby Jr. | Psychiatry & Neurology | 3500 Zanker Rd, San Jose, CA 95134-2299 | 2006-06-22 |
| 1942246202 | Usha S Belani | General Practice | 3500 Zanker Rd, San Jose, CA 95134-2299 | 2006-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013433945 | Jessica Roberson | Speech-Language Pathologist | 330 Crescent Village Circle, San Jose, CA 95134 | 2017-08-22 |
| 1407221948 | Bay Area Behavioral Group | Community/Behavioral Health | 4423 Fortran Court, #136, San Jose, CA 95134 | 2015-12-09 |
| 1891114500 | Adriane Jones | Occupational Therapist | 640 Epic Way, Apartment #271, San Jose, CA 95134 | 2014-04-09 |
| 1255758165 | Adam Moreno | Counselor | 2625 Zanker Rd., San Jose, CA 95134 | 2014-03-28 |
| 1972938801 | Claudine Lott | Family Medicine | 145 Nicholson Ln, San Jose, CA 95134 | 2013-09-11 |
| 1659611556 | 360 Degree Customer Inc | Early Intervention Provider Agency | 4423 Fortran Drive, # 114, San Jose, CA 95134 | 2013-03-01 |
| 1629392022 | Harrison James Kornfield | Surgery | 455 Navaro Way, #108, San Jose, CA 95134 | 2010-03-15 |
| 1538348008 | Roxanne F Ubana | Counselor | 4423 Fortran Ct Ste 136, San Jose, CA 95134 | 2007-10-31 |
| 1538351044 | William Lopez Robles | Counselor | 2625 Zanker Road, San Jose, CA 95134 | 2007-08-17 |
| 1881717296 | Chloe Chu | Dentist | 3720 N. First Street, Suite C, San Jose, CA 95134 | 2007-04-09 |
| Find all providers in zip 95134 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518390483 | Almond Home II Inc | Intermediate Care Facility, Mentally Retarded | 2551 Gumdrop Dr, San Jose, CA 95148-2019 | 2013-08-15 |
| 1053659086 | Mcr Care Inc. | Intermediate Care Facility, Mentally Retarded | 2223 Golden Dew Cir, San Jose, CA 95121-1441 | 2013-01-25 |
| 1932404555 | Emerald Key Villa Inc | Intermediate Care Facility, Mentally Retarded | 15860 Siesta Vista Drive, San Jose, CA 95127 | 2011-01-12 |
| 1396995072 | Circle of Care Corporation | Intermediate Care Facility, Mentally Retarded | 2130 Turnhouse Lane, San Jose, CA 95121-1377 | 2008-09-30 |
| 1912163031 | Tupaz Home # 14 | Intermediate Care Facility, Mentally Retarded | 14716 Union Ave, San Jose, CA 95124-3574 | 2008-07-29 |
| 1790949303 | Silver Punzalan II Inc | Intermediate Care Facility, Mentally Retarded | 2928 Silver Est, San Jose, CA 95135-1234 | 2008-07-12 |
| 1205019767 | Mouri Management Group Incorporated | Intermediate Care Facility, Mentally Retarded | 2492 Aram Ave, San Jose, CA 95128-4209 | 2007-12-07 |
| 1922219476 | Tupaz Home # 3 | Intermediate Care Facility, Mentally Retarded | 1955 Patio Dr, San Jose, CA 95125-5652 | 2007-05-25 |
| 1518178904 | Tupaz Home # 10 | Intermediate Care Facility, Mentally Retarded | 2893 Ross Ave, San Jose, CA 95124-1848 | 2007-05-25 |
| 1841401213 | Tupaz Home # 7 | Intermediate Care Facility, Mentally Retarded | 308 Marti Way, San Jose, CA 95136-2135 | 2007-05-25 |
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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.