NPIMap

Organization Active NPI

St. Jude Hospital Yorba Linda

  • Non-Pharmacy Dispensing Site
  • Irvine, CA
National Provider Identifier
1306384185
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
ST. JUDE HOSPITAL YORBA LINDA
Practice address
4 Park PLZ
Suite 150
Irvine, CA 92614-8560
Phone
(949) 430-3963
Fax
(949) 430-3964
NPI assigned
Feb 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Authorized official

Name
John Bennett
Title
Chief Administration Officer
Phone
(714) 449-4942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

4 Park PLZ
Suite 150
Irvine, CA 92614-8560

Mailing address

4 Park PLZ
Suite 150
Irvine, CA 92614-8560
Phone (949) 430-3963

Other names 1

  • Wellness-Jamboree Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Heritage HLTH FNDN44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1306384185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PARK PLZ",
            "address_2": "SUITE 150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148560",
            "telephone_number": "949-430-3963",
            "fax_number": "949-430-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PARK PLZ",
            "address_2": "SUITE 150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926148560",
            "telephone_number": "949-430-3963",
            "fax_number": "949-430-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE HOSPITAL YORBA LINDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATION OFFICER",
        "authorized_official_telephone_number": "714-449-4942"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness-Jamboree Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.