Jerida Lane Residential Care

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

347003312 Issued in CA

Legal business name

JERIDA LANE RESIDENTIAL CARE

Practice address

8830 Jerida LN
Fair Oaks, CA 95628-5470

Phone

(916) 606-8241

Fax

(916) 863-0668

NPI assigned

Jul 11, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Estrellita De Mesa Olea

Title

Licensee/Administrator

Phone

(916) 606-8241

Specialties & licenses 1

Addresses

Tax ID family

Jerida Lane Residential Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Residences-Fair Oaks

  • Physical Disabilities Residential Treatment Facility
  • Fair Oaks, CA
  • NPI 1902051857
  NPD tax ID

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1154585883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8830 JERIDA LN",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285470",
            "telephone_number": "916-606-8241",
            "fax_number": "916-863-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8830 JERIDA LN",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285470",
            "telephone_number": "916-606-8241",
            "fax_number": "916-863-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERIDA LANE RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "OLEA",
        "authorized_official_first_name": "ESTRELLITA",
        "authorized_official_middle_name": "DE MESA",
        "authorized_official_title_or_position": "LICENSEE/ADMINISTRATOR",
        "authorized_official_telephone_number": "916-606-8241",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "CA",
            "license": "347003312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy J Jackson, D.C., FIAMA
• Jeff Elliot Jacobson
• James R. Musser, DDS, Inc.
• Brian Dee Jenkins, D.C.
• Jenna Vivaldi Therapy
• Leslie Jimenez
• John Carson DDS Ms Inc
• John L Johnson DDS and Todd L Johnson DDS Inc
• Audrey Johnson
• Jamie Elizabeth Johnson, LPCC

• Physical Disabilities Residential Treatment Facility in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Physical Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.