Jo Mi Icf DDN Facilities

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

JO MI ICF DDN FACILITIES

Practice address

2128 Shirlee St
West Covina, CA 91792-2431

Phone

(626) 854-0670

NPI assigned

Feb 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Roger V. Cuevas

Title

Business Manager

Phone

(818) 841-1044

Specialties & licenses 3

Addresses

Other identifiers 3

Tax ID family

Jo Mi Icf DDN Facilities3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Jomi Alta5 Icfdd N

  dba Jomi Icfddn

  • Nursing Facility/Intermediate Care Facility
  • Altadena, CA
  • NPI 1124169537
  NPD tax ID
• Jomi Broadmoor Icfddn

  dba Jomi Icfddn

  • Nursing Facility/Intermediate Care Facility
  • West Covina, CA
  • NPI 1801937214
  NPD tax ID

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316085947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 AYERS WAY",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915011106",
            "telephone_number": "818-841-1044",
            "fax_number": "818-841-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 SHIRLEE ST",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922431",
            "telephone_number": "626-854-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JO MI ICF DDN FACILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUEVAS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "818-841-1044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE",
            "identifier": "LTC80382F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE",
            "identifier": "LTC80031F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE",
            "identifier": "LTC80142F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clarissa Joy Johnson

• Nursing Facility/Intermediate Care Facility in West Covina, CA
• Providers in West Covina, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.