NPIMap

Organization Active NPI

Providence Saint John's Health Center

  • Community/Behavioral Health Agency
  • Santa Monica, CA
National Provider Identifier
1184750168
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
569538 Issued in CA
Legal business name
PROVIDENCE SAINT JOHN'S HEALTH CENTER
Practice address
1339 20TH St
Santa Monica, CA 90404-2033
Phone
(310) 829-8921
Fax
(310) 829-8455
NPI assigned
Feb 26, 2007
Last updated
Apr 21, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PROVIDENCE SAINT JOHN'S HOSPITAL AND HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Mrs. Ruth Canas, LCSWNPI 1659408524
Title
Outpatient Director
Phone
(310) 829-8921

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
Community/Behavioral Health Agency 251S00000X 569538 CA Primary

Addresses

Primary practice location

1339 20TH St
Santa Monica, CA 90404-2033

Mailing address

1339 20TH St
Santa Monica, CA 90404-2033
Phone (310) 829-8921

Other identifiers 1

IdentifierTypeStateIssuer
000006792MedicaidCA

Other names 1

  • Providence Saint Johns Health CID Other name

National Provider Directory

National Provider Directory
Tax ID family
Saint Johns Hospital and4 organizations share this tax ID, including this one
Part of
Saint Johns Hospital and

Other organizations with this tax ID 3

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

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1184750168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 20TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042033",
            "telephone_number": "310-829-8921",
            "fax_number": "310-829-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 20TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042033",
            "telephone_number": "310-829-8921",
            "fax_number": "310-829-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SAINT JOHN'S HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE SAINT JOHN'S HOSPITAL AND HEALTH CENTER",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CANAS",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OUTPATIENT DIRECTOR",
        "authorized_official_telephone_number": "310-829-8921",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "569538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000006792",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Saint Johns Health CID",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.