Pacific Crest Hospice of the High Desert LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PACIFIC CREST HOSPICE OF THE HIGH DESERT LLC

Practice address

13300 11TH Street
Victorville, CA 92395

Phone

(760) 808-2646

NPI assigned

Oct 25, 2021

Last updated

Dec 14, 2021By 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

Jose Lynch

Title

Managing Member

Phone

(714) 673-6810

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1396409561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EXCHANGE STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926021340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 11TH STREET",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-808-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CREST HOSPICE OF THE HIGH DESERT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "714-673-6810"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Owen
• Wende M Owen, CNM
• Seth Owuor
• P and a Health Services
• P.H.N. Pharmacies Inc (Allcare Pharmacy)
• Pacific Dental Services
• Pacific Dental Services
• Pacific Family Medical Inc (Night Owl Family Urgent Care)
• Pacifica Sierra Vista LP (Sierra Vista Independent and Assisted Living)
• Karmen Padfield, FNP-C

• Community Based Hospice Care Agency in Victorville, CA
• Providers in Victorville, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.