Parkside Special Care Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

080000068 Issued in CA

Legal business name

PARKSIDE SPECIAL CARE CENTER INC

Doing business as

Shea Family Care Parkside

Practice address

444 W Lexington Ave
El Cajon, CA 92020-4416

Phone

(619) 442-7744

Fax

(619) 442-1137

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mary Patricia Miller

Title

Chief Legal Counsel

Phone

(619) 441-8771

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shea Family Care Parkside Doing business as

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1306859970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W LEXINGTON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204416",
            "telephone_number": "619-442-7744",
            "fax_number": "619-442-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W LEXINGTON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920204416",
            "telephone_number": "619-442-7744",
            "fax_number": "619-442-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE SPECIAL CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF LEGAL COUNSEL",
        "authorized_official_telephone_number": "619-441-8771",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "080000068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT18176H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shea Family Care Parkside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tari Y Park, MD
• Beverly Susan Parker Dennis, MFT
• Lozen Parker Pittman
• Kristina Parker, PPS
• Parkside Healthcare, Inc.
• Briana Parra
• Ian Christopher So Parra
• Kathleen Parra, LVN
• Maritza Parra
• Breno Parsons

• Skilled Nursing Facility in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.