Skilled Marengo LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SKILLED MARENGO LLC

Practice address

5480 Marengo Ave
La Mesa, CA 91942-2408

Phone

(619) 463-0281

NPI assigned

Jul 9, 2025

Organization subpart

No

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

Authorized official

Name

Scott Kirby

Title

Manager

Phone

(619) 201-5888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1053202077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 AVENIDA DEL DIABLO",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920293112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 MARENGO AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422408",
            "telephone_number": "619-463-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILLED MARENGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-201-5888"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Simon, DMD
• Tracy Ann Simoncini
• Joel Andres Siria, LMFT
• Elizabeth V Sison
• Sean Christopher Skelton, D.O.
• Leann C. Skimming
• Bonny Jean Skolnik
• Mikhail Skvolygin, RCP, RRT
• Jan Slack, MFT
• Brittany Slaughter

• Skilled Nursing Facility in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.