CCWF (NPI# 1790031995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790031995 |
| Entity Type | Organization |
| Organization Name | CCWF |
| Practice Address |
3688 Boyer Cir Lafayette CA 94549-4904 |
| Practice Telephone | 5109107244 |
| Mailing Telephone | 5109107244 |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |
| Authorized Official Name | DR. DONALD DE ZORDO (PHARM D) |
| Authorized Official Telephone | 5596655531 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | RPH23059 | CA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588934806 | Ccwf | Case Management | 23370 Road 22, Chowchilla, CA 93610-8504 | 2012-01-03 |
| Street Address |
3688 BOYER CIR |
| City | LAFAYETTE |
| State | CA |
| Zip Code | 94549-4904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427004 | Veronica Adelaid Valera-averilla | Behavior Technician | 3650 Mt Diablo Blvd. Ste. 107, Lafayette Ca Contra, CA 94549 | 2020-11-06 |
| 1679128870 | Zong Ning Zhou | Behavior Technician | 3650 Mt.diablo Blvd., Suite 107, Lafayette, CA 94549 | 2019-08-05 |
| 1912551227 | Tamiesha Jackson | Behavior Technician | Ste Consultant, LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2019-07-25 |
| 1528525375 | Tiara Lajai Aubrey | Behavior Technician | 3560 Mt. Diablo Blvd, Suite 107, Layfatte, CA 94549 | 2019-02-28 |
| 1215409990 | Marisa Della Marmolejo | Case Manager/Care Coordinator | Ste Consultants, LLC 3650 Mt Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-12-19 |
| 1235608399 | Andrew Thompson | Behavior Technician | 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-11-19 |
| 1982172953 | Amber Jackson | Behavior Technician | Ste, LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-11-08 |
| 1104393396 | Alexis Taper | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-10-26 |
| 1023508793 | Alyssa Savinovich | Behavior Technician | 3560 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-05-17 |
| 1831689140 | Kannambra M Raja | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-05-11 |
| Find all providers in zip 94549 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659767713 | Dustin Dorsey | PACE Provider Organization | 203 Hallmark Ave, Lafayette, LA 70508-7766 | 2015-04-15 |
| 1568773299 | Luci,s Troop Ltc LLC | PACE Provider Organization | 111 Rubria St, Lafayette, LA 70501-1735 | 2010-06-28 |
| 1083073050 | Tru Community Care | PACE Provider Organization | 2593 Park Ln, Lafayette, CO 80026-3172 | 2016-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
| 1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1669037362 | Medrev | PACE Provider Organization | 558 Chelsea Way, Corona, CA 92879-5880 | 2019-05-08 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
| 1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
| 1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1063901767 | Humboldt Mobile Massage, Inc | PACE Provider Organization | 1737 Margaret Ln, Arcata, CA 95521-6838 | 2018-05-08 |
| 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.