NPIMap

Organization Active NPI

Normal Life of California, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Azusa, CA
National Provider Identifier
1003943838
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
NORMAL LIFE OF CALIFORNIA, INC.
Practice address
1361 N Brian Ave
Azusa, CA 91702-1802
Phone
(714) 537-3252
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
Chief Regulatory Officer Sr Asst GC
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

1361 N Brian Ave
Azusa, CA 91702-1802

Mailing address

6600 France Ave S Ste 350
Edina, MN 55435-1810
Phone (800) 388-5150

Other identifiers 1

IdentifierTypeStateIssuer
LTC60935FMedicaidCA

Other names 1

  • BRIAN HOUSE Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G307

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BRIAN AVENUE HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 5, 1999
Last certification
Dec 18, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
1361 Brian Avenue
Azusa, CA 91702

National Provider Directory

National Provider Directory
Tax ID family
Normal Life California13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1003943838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "800-388-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 N BRIAN AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917021802",
            "telephone_number": "714-537-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMAL LIFE OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF REGULATORY OFFICER SR ASST GC",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60935F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIAN HOUSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Azusa, CA

Sources for this page

Verify at the official NPI Registry.