South Bay Serenity Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTH BAY SERENITY INC

Practice address

1080 Via la Paz
San Pedro, CA 90732

Phone

(310) 985-1059

Fax

(310) 787-7303

NPI assigned

Aug 8, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Evangeline Atiagan Agatep, BS ACCOUNTING

Title

President

Phone

(310) 985-1059

Specialties & licenses 1

Addresses

Other names 1

• CASA ESPERANZA & CASA DEL SUR Other name

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1346071701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 VIA LA PAZ",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-985-1059",
            "fax_number": "310-787-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 VIA LA PAZ",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "90732",
            "telephone_number": "310-985-1059",
            "fax_number": "310-787-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY SERENITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "AGATEP",
        "authorized_official_first_name": "EVANGELINE",
        "authorized_official_middle_name": "ATIAGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-985-1059",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS ACCOUNTING"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASA ESPERANZA & CASA DEL SUR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Source 1 Behavioral Services, LLC
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• South Bay DME, LLC
• Southern California Emergency Medical Group
• Spark Physician Assistant Services, Inc.
• Keisanna Dranee' Sparrow
• Peter Jr. Spennato, D.D.S.
• Sponderworks Childrens Services

• Assisted Living Facility in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.