NPIMap

Organization Active NPI

State of California

  • Skilled Nursing Facility
  • Vacaville, CA
National Provider Identifier
1285910729
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
A91928 Issued in CA
Legal business name
STATE OF CALIFORNIA
Practice address
1600 California Drive
Vacaville, CA 95687
Phone
(707) 448-6841
NPI assigned
Oct 28, 2011
Last updated
Oct 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Dr. Joseph Bick, MD
Title
Chief Medical Executive
Phone
(707) 448-6841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X A91928 CA Primary

Addresses

Primary practice location

1600 California Drive
Vacaville, CA 95687

Mailing address

1602 Spring St
Mountain View, CA 94043-1814
Phone (707) 761-1675

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1319760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1285910729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 SPRING ST",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431814",
            "telephone_number": "707-761-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CALIFORNIA DRIVE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-448-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-28",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "BICK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF MEDICAL EXECUTIVE",
        "authorized_official_telephone_number": "707-448-6841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "A91928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.