NPIMap

Organization Active NPI

Total Renal Care Inc

Doing business as San Quentin Prison Program

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Quentin, CA
National Provider Identifier
1023438645
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
TOTAL RENAL CARE INC
Doing business as
San Quentin Prison Program
Practice address
1 Main St
San Quentin, CA 94964-1000
Phone
(415) 444-0376
NPI assigned
Apr 22, 2014
Last updated
Apr 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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

Authorized official

Name
Nicole Clarke
Title
Assistant Regional Revenue Manager
Phone
(949) 930-6874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1 Main St
San Quentin, CA 94964-1000

Mailing address

15253 Bake Pkwy
Irvine, CA 92618-2502
Phone (949) 930-4400

Other names 1

  • SAN QUENTIN PRISON PROGRAM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hernando Kidney Center758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1023438645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15253 BAKE PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182502",
            "telephone_number": "949-930-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "SAN QUENTIN",
            "state": "CA",
            "postal_code": "949641000",
            "telephone_number": "415-444-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL RENAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "ASSISTANT REGIONAL REVENUE MANAGER",
        "authorized_official_telephone_number": "949-930-6874"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN QUENTIN PRISON PROGRAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Quentin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.