Ivy Cottages III

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IVY COTTAGES III

Practice address

16840 Mount Eden St
Fountain Valley, CA 92708-2518

Phone

(714) 775-1128

NPI assigned

May 10, 2021

Organization subpart

No

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

Authorized official

Name

Carmen Rodriguez

Title

Owner/Administrator

Phone

(714) 775-1128

Specialties & licenses 1

Addresses

Tax ID family

Ivy Cottages I3 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.

• Ivy Cottages I

  • Assisted Living Facility
  • Fountain Valley, CA
  • NPI 1366018087
  NPD tax ID
• Ivy Cottages II

  • Assisted Living Facility
  • Fountain Valley, CA
  • NPI 1437946530
  NPD tax ID

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1356925911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16840 MOUNT EDEN ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082518",
            "telephone_number": "714-775-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16840 MOUNT EDEN ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082518",
            "telephone_number": "714-775-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY COTTAGES III",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "714-775-1128"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susana Isidoro
• Isight Vision Care, Inc (iSight Vision Care)
• Maria Elena Iturralde, RBT
• Ivy Cottages I
• Ivy Cottages II
• Nwanyieze Iyalomhe
• Jack F Jacoub MD Inc
• Joshua Robert Jackson, APRN
• Kathlyn Tan Jackson, MT
• Lisa Jacobs, M.D.

• Assisted Living Facility in Fountain Valley, CA
• Providers in Fountain Valley, 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 May 18, 2021; 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.