NPIMap

Organization Active NPI

State of California - Department of Developmental Services

Doing business as Lanterman Developmental Center

  • General Acute Care Hospital
  • Pomona, CA
National Provider Identifier
1154372498
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
170000772 Issued in CA
Legal business name
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Doing business as
Lanterman Developmental Center
Practice address
3530 Pomona Blvd
Pomona, CA 91768-3238
Phone
(909) 595-1221
Fax
(909) 595-7252
NPI assigned
May 12, 2006
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Carla Castaneda
Title
Chief Deputy Director
Phone
(916) 654-2282

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 170000772 CA Primary
Nursing Facility/Intermediate Care Facility 313M00000X 170000772 CA
Skilled Nursing Facility 314000000X 170000772 CA
Intellectual Disabilities Intermediate Care Facility 315P00000X 170000772 CA
Pharmacy 333600000X 170000772 CA

Addresses

Primary practice location

3530 Pomona Blvd
Pomona, CA 91768-3238

Mailing address

PO Box 944202 1215 O Street Ms 10-30
Sacramento, CA 94244-2020
Phone (916) 654-3463

Other names 1

  • LANTERMAN DEVELOPMENTAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081114000496 CA Part B Supplier - Clinic/Group Practice 4082788732 Receives reassigned benefits from 73 practitioners
7 other NPIs on this enrollment
Practice locations: Cathedral City, CA; Costa Mesa, CA; Porterville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154372498. Details of each certification follow.

Hospital certification: CCN 050545

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
LANTERMAN DEVELOPMENTAL CENTER
Certification status
Terminated Voluntary: merger or closure, Dec 31, 2014
Provider type (POS)
Hospital – Short-term
Participating since
Nov 1, 1968
Last certification
Dec 22, 2011
Beds
39
Ownership / control type
State
Facility address
3530 Pomona Boulevard
Pomona, CA 91768

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Porterville Developmental CenterPorterville, CA, CCN 050546 Hospital Operational/Managerial Control (100%) Jul 21, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 73

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.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1154372498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 944202 1215 O STREET MS 10-30",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942442020",
            "telephone_number": "916-654-3463",
            "fax_number": "916-653-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 POMONA BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683238",
            "telephone_number": "909-595-1221",
            "fax_number": "909-595-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CHIEF DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "916-654-2282"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "170000772",
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "170000772",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "170000772",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "170000772",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "170000772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LANTERMAN DEVELOPMENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LANTERMAN DEVELOPMENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.