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Organization Active NPI

St Joseph Hospital of Orange

Doing business as Providence St. Joseph Hospital

  • Psychiatric Hospital Unit
  • Orange, CA
National Provider Identifier
1285619254
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
060000172 Issued in CA
Legal business name
ST JOSEPH HOSPITAL OF ORANGE
Doing business as
Providence St. Joseph Hospital
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(714) 633-9111
Fax
(714) 744-8570
NPI assigned
Dec 13, 2005
Organization subpart
Yes
Parent organization
ST JOSEPH HOSPITAL OF ORANGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 060000172 CA Primary

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

1100 W Stewart Dr
Orange, CA 92868-3849

Other names 1

  • PROVIDENCE ST. JOSEPH HOSPITAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120312000796 CA Part A Provider - Hospital 9234227612 Practice locations: Orange, CA

Hospital certification: CCN 05S069

Legal name
ST JOSEPH HOSPITAL OF ORANGE
Doing business as
PROVIDENCE ST. JOSEPH HOSPITAL
Organization structure
OtherNon-profit
Incorporated
Nov 26, 1941 in CA
Enrollment address
1100 W Stewart Dr
Orange, CA 92868-3849
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Hospital of Orange7 organizations share this tax ID, including this one
Part of
St Joseph Hospital of Orange

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Jon Coleman Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Kathleen O'Leary Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Karen a Clock Individual Corporate DirectorDirector Jan 1, 2020
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Jul 1, 2016
Ruben Smith Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Kevin Snyder Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Peter R Smethurst Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Kenneth J Cosgrove Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Christopher a Wills Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
James Martin Individual Corporate OfficerAuthorized Official Jan 13, 2023
Judith Dugan Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Jeremy S Zoch Individual Corporate OfficerCeo Feb 1, 2017
W-2 Managing EmployeeCeo Apr 23, 2012
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary for Enrollment May 18, 2018
Eileen Haubl Individual Corporate OfficerCfo Aug 15, 2020
W-2 Managing EmployeeCfo Aug 15, 2020
Gregory David Hoffman Individual Corporate OfficerPresident/Ceo & Treasurer Oct 1, 2020
Mary Anne Foo Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit Other Jul 1, 1984
Suzanne Sassus Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Michelle Suzette Hobby-Mears Individual Corporate DirectorDirector Jan 1, 2022
St Joseph Hospital of Orange Organization, Orange, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Sudeep Kukreja Individual Corporate DirectorMember, Board of Trustees Jan 1, 2020
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Providence St. Joseph HospitalOrange, CA, CCN 050069 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 139

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

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1285619254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-633-9111",
            "fax_number": "714-744-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HOSPITAL OF ORANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST JOSEPH HOSPITAL OF ORANGE",
        "enumeration_date": "2005-12-13",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CA",
            "license": "060000172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE ST. JOSEPH HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.