NPIMap

Organization Active NPI

California Department of Corrections and Rehabilitation

  • Skilled Nursing Facility
  • Vacaville, CA
National Provider Identifier
1053690982
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
A91928 Issued in CA
Legal business name
CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Practice address
1600 California Dr
Vacaville, CA 95696
Phone
(707) 448-6841
NPI assigned
Aug 9, 2011
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Dr. Joseph Bick, MDNPI 1801088935
Title
Chief Medical Executive
Phone
(707) 449-6576

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X A91928 CA Primary

Addresses

Primary practice location

1600 California Dr
Vacaville, CA 95696

Mailing address

1600 California Dr.
Vacaville, CA 95696
Phone (707) 448-6841

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1053690982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CALIFORNIA DR.",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95696",
            "telephone_number": "707-448-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CALIFORNIA DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95696",
            "telephone_number": "707-448-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "BICK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF MEDICAL EXECUTIVE",
        "authorized_official_telephone_number": "707-449-6576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "A91928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.