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Kaiser Foundation Hospitals

Organization Active NPI Home Health Agency · Vallejo, CA

NPI 1215008461 · NPPES record last updated Apr 23, 2021

Key facts

NPI
1215008461
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
010000008 (CA)
Legal business name
KAISER FOUNDATION HOSPITALS
Practice address
1761 Broadway St
Suite 210
Vallejo, CA 94589-2226
Phone
(707) 651-1000
NPI assigned
Nov 10, 2006
Organization subpart
No

Authorized official

Name
Norair Jemjemian
Title
Senior Vice President, Area Manager
Phone
(707) 651-5414

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Corporate family (same tax ID) 24

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

Facilities with the same owner 78

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 78

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Kaiser Foundation Hospital Home Health - Vallejo CCN 557062
Overall star rating
★★★☆☆ 2.5 of 5
Ownership
Non-Profit
Certified
Jan 1, 1990
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Home health agency certification: CCN 557062

Legal name
KAISER FOUNDATION HOSPITALS
Doing business as
KAISER FOUNDATION HOSPITAL HOME HEALTH VALLEJO
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 1, 1990
Last certification
Jun 29, 2017
Ownership / control type
Non-Profit
Organization structure
Corporation · Non-profit
Incorporated
Feb 19, 1948 in CA
Enrollment address
1761 Broadway St Ste 210
Vallejo, CA 94589-2226

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David J Barger
Individual 		Corporate Director
Board Member		 May 1, 2016
Margaret E Porfido
Individual 		Corporate Director
Board Member		 Nov 1, 2011
Jenny Ming
Individual 		Corporate Director
Board Member		 Jul 6, 2021
Richard P Shannon
Individual 		Corporate Director
Board Member		 Jul 1, 2014
Regina M Benjamin
Individual 		Corporate Director
Board Member		 Jun 1, 2015 100%
Judith a Johansen
Individual 		Corporate Director
Board Member		 Apr 1, 2006
Darryl Curry
Individual 		Corporate Officer
Sr VP/Area Manager		 Nov 7, 2022
W-2 Managing Employee
Sr VP/Area Manager		 Nov 7, 2022
Operational/Managerial Control
Sr VP/Area Manager		 Nov 7, 2022
Douglas a Lemieux
Individual 		W-2 Managing Employee
Sr Director		 Jul 8, 2018
David F Hoffmeister
Individual 		Corporate Director
Board Member		 Nov 1, 2014
Carrie a Owen Plietz
Individual 		Corporate Officer
Regional President, Northern Ca		 Nov 9, 2020
Kaiser Foundation Hospitals
Organization · Oakland, CA
Non-profit 		Operational/Managerial Control Jan 1, 1998
Arnold Eugene Washington
Individual 		Corporate Director
Board Member		 Jan 4, 2016
Ines Gaeta
Individual 		Operational/Managerial Control
Controller & Executive Director		 Apr 4, 2022
Jeffrey E Epstein
Individual 		Corporate Director
Board Member		 Apr 1, 2013
Teresa Ramirez
Individual 		W-2 Managing Employee
Business Process Consultant		 Sep 29, 2016
Ramon F Baez
Individual 		Corporate Director
Board Member		 Jun 4, 2016
Gregory a Adams
Individual 		Corporate Officer
Chairman & Ceo		 Nov 11, 2019
Corporate Director
Chairman & Ceo		 Nov 11, 2019
Matthew T Ryan
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Leslie S Heisz
Individual 		Corporate Director
Board Member		 Jan 1, 2015

All facility ownership & control disclosures 79

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

FacilityTypeRoleSince
Kaiser Sunnyside Medical Center
Clackamas, OR · CCN 380091		 Hospital Operational/Managerial Control (100%) Jan 5, 2007
Kaiser Foundation Hospital - Santa Clara
Santa Clara, CA · CCN 050071		 Hospital Operational/Managerial Control (100%) Jul 24, 2007
Kaiser Foundation Hospital - Manteca
Manteca, CA · CCN 050748		 Hospital Operational/Managerial Control (100%) Nov 1, 2004
Kaiser Foundation Hospital Los Angeles
Los Angeles, CA · CCN 050138		 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Kaiser Foundation Hospitals - Orange County - Anaheim
Anaheim, CA · CCN 050609		 Hospital Operational/Managerial Control (100%) May 1, 1979
Kaiser Foundation Hospital - Antioch
Antioch, CA · CCN 050760		 Hospital Operational/Managerial Control (100%) Apr 27, 2007
Kaiser Foundation Hospital - Santa Rosa
Santa Rosa, CA · CCN 050690		 Hospital Operational/Managerial Control (100%) Apr 18, 1990
Kaiser Foundation Hospital - Sacramento
Sacramento, CA · CCN 050425		 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Kaiser Foundation Hospital-Riverside
Riverside, CA · CCN 050686		 Hospital Operational/Managerial Control (100%) Sep 11, 1989
Kaiser Foundation Hospital Oakland Richmond
Oakland, CA · CCN 050075		 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital San Jose
San Jose, CA · CCN 050604		 Hospital Operational/Managerial Control (100%) Dec 1, 1976
Kaiser Foundation Hospital - Moreno Valley
Moreno Valley, CA · CCN 050765		 Hospital Operational/Managerial Control (100%) Dec 18, 2008
Kaiser Foundation Hospital - Vallejo
Vallejo, CA · CCN 050073		 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital - Vallejo
Vallejo, CA · CCN 05T073		 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital Baldwin Park
Baldwin Park, CA · CCN 050723		 Hospital Operational/Managerial Control Feb 19, 1948
Kaiser Foundation Hospital - Fontana
Fontana, CA · CCN 050140		 Hospital Operational/Managerial Control (100%) Nov 2, 2007
Kaiser Foundation Hospital-Downey
Downey, CA · CCN 050139		 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital San Diego
San Diego, CA · CCN 050515		 Hospital Operational/Managerial Control (100%) Jul 13, 2009
Kaiser Foundation Hospital Walnut Creek
Walnut Creek, CA · CCN 050072		 Hospital Operational/Managerial Control Jul 1, 1966
Kaiser Foundation Hospital Woodland Hills
Woodland Hills, CA · CCN 050677		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital Panorama City
Panorama City, CA · CCN 050137		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital Fresno
Fresno, CA · CCN 050710		 Hospital Operational/Managerial Control Feb 28, 1995
Kaiser Foundation Hospital-South Bay
Harbor City, CA · CCN 050411		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital San Francisco
San Francisco, CA · CCN 050076		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital West Los Angeles
Los Angeles, CA · CCN 050561		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital South San Francisco
South San Francisco, CA · CCN 050070		 Hospital Operational/Managerial Control Jan 1, 1996
Kaiser Foundation Hospital South Sacramento
Sacramento, CA · CCN 050674		 Hospital Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital San Rafael
San Rafael, CA · CCN 050510		 Hospital Operational/Managerial Control Jul 1, 1966
Kaiser Foundation Hospital - Redwood City
Redwood City, CA · CCN 050541		 Hospital Operational/Managerial Control Jul 1, 1966
Kaiser Foundation Hospital
Honolulu, HI · CCN 120011		 Hospital Operational/Managerial Control Jul 1, 1966
Kaiser Foundation Hospital Los Angeles
Los Angeles, CA · CCN 05S138		 Hospital Operational/Managerial Control Jul 1, 1966
Kaiser Foundation Hospital-Fremont
Fremont, CA · CCN 050512		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital-Vacaville
Vacaville, CA · CCN 050767		 Hospital Operational/Managerial Control (100%) Sep 16, 2009
Kaiser Permanente Psyciatric Health Facility - Santa Clara
Santa Clara, CA · CCN 054150		 Hospital Operational/Managerial Control Nov 16, 2010
Kaiser Foundation Hospital-Roseville
Roseville, CA · CCN 050772		 Hospital Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital-Westside
Hillsboro, OR · CCN 380103		 Hospital Operational/Managerial Control Nov 9, 2012
Kaiser Foundation Hospital-San Leandro
San Leandro, CA · CCN 050777		 Hospital Operational/Managerial Control Jun 3, 2014
St Josephs Behavioral Health Center
Stockton, CA · CCN 054123		 Hospital 5% Or Greater Direct Ownership Interest (20%) May 1, 2016
St Josephs Medical Center of Stockton
Stockton, CA · CCN 050084		 Hospital 5% Or Greater Indirect Ownership Interest (20%) Jun 1, 2016
Lanai Community Hospital
Lanai City, HI · CCN 121305		 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 24, 2015
Maui Memorial Medical Center
Wailuku, HI · CCN 120002		 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2017
Kula Hospital
Kula, HI · CCN 121308		 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 24, 2015
Kula Hospital
Kula, HI · CCN 12Z308		 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 24, 2015
Kaiser Foundation Hospital San Marcos
San Marcos, CA · CCN 050855		 Hospital Operational/Managerial Control Jul 10, 2023
Lanai Community Hospital Skilled Nursing and Intermediate Care Facilit
Lanai City, HI · CCN 125023		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 24, 2015
Dec 24, 2015
Kula Skilled Nursing and Intermediate Care Facility
Kula, HI · CCN 125003		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 24, 2015
Jan 1, 2017
Kaiser Permanente Hospital Home Health Santa Rosa
Santa Rosa, CA · CCN 057407		 Home health agency Operational/Managerial Control (100%) Jun 15, 1993
KFH Home Health Agency - Oahu
Honolulu, HI · CCN 127022		 Home health agency Operational/Managerial Control (100%) Oct 11, 1993
Kaiser Permanente Hospital Home Health - Sacramento
Sacramento, CA · CCN 557061		 Home health agency Operational/Managerial Control Jul 6, 2015
Kaiser Foundation Hospital Los Angeles HHA
Pasadena, CA · CCN 057053		 Home health agency Operational/Managerial Control (100%) Jan 19, 2015
Kaiser Riverside Home Health Agency (Parent)
Corona, CA · CCN 557037		 Home health agency Operational/Managerial Control (100%) Apr 13, 1989
Kaiser Permanente Hospital Tri Central HHA
Downey, CA · CCN 057794		 Home health agency Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital-Home Health Agency
Fontana, CA · CCN 058068		 Home health agency Operational/Managerial Control (100%) Oct 8, 2007
Kaiser Foundation Hospital Anaheim HHA
Tustin, CA · CCN 057799		 Home health agency Operational/Managerial Control May 1, 2002
Kaiser Foundation Hospital Home Health - Oakland
Oakland, CA · CCN 557068		 Home health agency Operational/Managerial Control (100%) Aug 4, 2017
Kaiser Permanente Hospital Home Health Martinez
Martinez, CA · CCN 557012		 Home health agency Operational/Managerial Control (100%) Jan 2, 1998
Kaiser Permanente Continuing Care Services Home Health
Portland, OR · CCN 387007		 Home health agency Operational/Managerial Control (100%) Jan 1, 1978
Kaiser Foundation Hospital HHA Santa Clara
Santa Clara, CA · CCN 557066		 Home health agency Operational/Managerial Control (100%) May 1, 1991
Kaiser Foundation Hospital Home Health San Francisco
San Francisco, CA · CCN 057071		 Home health agency Operational/Managerial Control (100%) Aug 1, 1966
Kaiser Foundation Hospital San Diego HHA
San Diego, CA · CCN 057797		 Home health agency Operational/Managerial Control (100%) Jul 1, 1983
Kaiser Permanente Hospital Home Health Novato
Novato, CA · CCN 557065		 Home health agency Operational/Managerial Control (100%) Jan 1, 1990
Kaiser Permanente Home Health Agency Mau
Wailuku, HI · CCN 127023		 Home health agency Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital Valleys Continuing Care-HHA
Woodland Hills, CA · CCN 057795		 Home health agency Operational/Managerial Control Dec 16, 1994
St Josephs Medical Center Home Health
Stockton, CA · CCN 057212		 Home health agency 5% Or Greater Indirect Ownership Interest (20%) Jun 1, 2016
Kaiser Permanente Hospital Sacramento Hospice
Sacramento, CA · CCN 051546		 Hospice Operational/Managerial Control Feb 14, 1989
Kaiser Permanente Hospital Hospice Program
Downey, CA · CCN 051504		 Hospice Operational/Managerial Control (100%) Dec 13, 1996
Kaiser Foundation Hospital Hospice Oakland
Oakland, CA · CCN 051551		 Hospice Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Permanente Hospital San Diego Hospice
San Diego, CA · CCN 051522		 Hospice Operational/Managerial Control (100%) Jul 13, 2009
Kaiser Permanente Continuing Care Services Hospice
Portland, OR · CCN 381502		 Hospice Operational/Managerial Control (100%) Jan 1, 1978
Kaiser Permanente Hospital Hospice - Martinez
Martinez, CA · CCN 051552		 Hospice Operational/Managerial Control (100%) Jan 1, 1966
Kaiser Foundation Hospital Hospice-Santa Clara
Santa Clara, CA · CCN 051589		 Hospice Operational/Managerial Control (100%) Mar 18, 1998
Kaiser Foundation Hospital Hospice Vallejo
Vallejo, CA · CCN 051565		 Hospice Operational/Managerial Control Jan 1, 1966
Kaiser Foundation Hospital Valleys Continuing Care-Hospice
Lancaster, CA · CCN 051521		 Hospice Operational/Managerial Control Jan 1, 1966
Kaiser Permanente Hospital San Francisco Hospice
San Francisco, CA · CCN 051582		 Hospice Operational/Managerial Control (100%) Sep 1, 1990
Kaiser Foundation Hospital Hospice Hayward
Union City, CA · CCN 051556		 Hospice Operational/Managerial Control (100%) Feb 19, 1989
Kaiser Foundation Hospital Los Angeles - Hospice
Pasadena, CA · CCN 051525		 Hospice Operational/Managerial Control Feb 2, 1987
Kaiser Permanente Hospital Fontana Hospice
Fontana, CA · CCN 051515		 Hospice Operational/Managerial Control Oct 8, 2007
Kaiser Permanente Hospital Riverside Hospice
Corona, CA · CCN 551743		 Hospice Operational/Managerial Control Jan 1, 1966
Kaiser Orange County Hospice
Tustin, CA · CCN 551634		 Hospice Operational/Managerial Control Dec 12, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081212000209 CA Part a Provider - Home Health Agency 6800707456 Practice locations: Vallejo, CA

National Provider Directory

Tax ID family
Kaiser Foundation (185 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 010000008 CA Yes

Addresses

Primary practice location

1761 Broadway St
Suite 210
Vallejo, CA 94589-2226

Mailing address

1761 Broadway St
Suite 210
Vallejo, CA 94589-2226
Phone (707) 651-1000

Other names

  • Kaiser Foundation Hospital Home Health Vallejo Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 23, 2021.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1215008461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BROADWAY ST",
            "address_2": "SUITE 210",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892226",
            "telephone_number": "707-651-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BROADWAY ST",
            "address_2": "SUITE 210",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892226",
            "telephone_number": "707-651-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "JEMJEMIAN",
        "authorized_official_first_name": "NORAIR",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT, AREA MANAGER",
        "authorized_official_telephone_number": "707-651-5414"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "010000008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1761 Broadway St",
            "address_2": "Suite 210",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Foundation Hospital Home Health Vallejo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Foundation Hospital Home Health Vallejo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vallejo, CA

All providers in Vallejo, CA · Home Health Agency in California

Sources for this page

Verify at the official NPI Registry.