VISTA PRADO INC (NPI# 1851940308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851940308 |
| Entity Type | Organization |
| Organization Name | VISTA PRADO INC |
| Practice Address |
105 Power Dr Vallejo CA 94589-2529 |
| Mailing Address |
1331 Alabama St Vallejo CA 94590-4602 |
| Practice Telephone | 7076437617 |
| Mailing Telephone | 7075309283 |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2019-09-07 |
| Authorized Official Name | TEDRA GODFREY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7078535133 |
| Authorized Official Credential | LVN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Vista Prado A Memory Care Community | Doing Business As Name - Organization |
| Street Address |
105 POWER DR |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425925 | Pacifica Newport Mesa LLC | Alzheimer Center (Dementia Center) | 2891 Bear St, Costa Mesa, CA 92626-4306 | 2020-10-22 |
| 1992304729 | Pacifica Riverside Sl Lp | Alzheimer Center (Dementia Center) | 6280 Clay St, Riverside, CA 92509-6005 | 2020-10-22 |
| 1235738071 | Pacifica Valley Crest Lp | Alzheimer Center (Dementia Center) | 18524 Corwin Rd, Apple Valley, CA 92307-2302 | 2020-10-22 |
| 1255930095 | Pacifica Senior Living Vacaville LLC | Alzheimer Center (Dementia Center) | 431 Nut Tree Rd, Vacaville, CA 95687-3508 | 2020-10-22 |
| 1689273401 | St Pauls Modesto Lp | Alzheimer Center (Dementia Center) | 2325 St Pauls Way, Modesto, CA 95355-3309 | 2020-10-22 |
| 1295332047 | Rvmur Operations Company | Alzheimer Center (Dementia Center) | 24271 Jackson Ave, Murrieta, CA 92562-1993 | 2020-10-05 |
| 1356980494 | Memory Spa, LLC | Alzheimer Center (Dementia Center) | 1950 Sunny Crest Dr Ste 1400, Fullerton, CA 92835-3642 | 2020-01-06 |
| 1821641507 | Ktre1, LLC | Alzheimer Center (Dementia Center) | 3219 Canon St, San Diego, CA 92106-2512 | 2019-07-22 |
| 1497229090 | Ktre3, LLC | Alzheimer Center (Dementia Center) | 7971 Culowee St, La Mesa, CA 91942-5509 | 2019-01-16 |
| 1760954291 | Pacifica Sl Hemet LLC | Alzheimer Center (Dementia Center) | 1177 South Palm Avenue, Hemet, CA 92543 | 2018-12-21 |
| 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.