Organization Active NPI

Paradise Hills Board and Care

  • Assisted Living Facility
  • San Diego, CA
National Provider Identifier
1104608470
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PARADISE HILLS BOARD AND CARE
Practice address
1580 Antoine Dr
San Diego, CA 92139-3948
Phone
(619) 838-4658
NPI assigned
Oct 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Mrs. Masho Woldegerima
Title
Owner/Caregiver
Phone
(619) 519-2591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1580 Antoine Dr
San Diego, CA 92139-3948

Mailing address

1580 Antoine Dr
San Diego, CA 92139-3948

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1104608470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 ANTOINE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921393948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 ANTOINE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921393948",
            "telephone_number": "619-838-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE HILLS BOARD AND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "WOLDEGERIMA",
        "authorized_official_first_name": "MASHO",
        "authorized_official_title_or_position": "OWNER/CAREGIVER",
        "authorized_official_telephone_number": "619-519-2591",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.