Organization Active NPI

LPCH Medical Group Div of Lucile

Doing business as Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
National Provider Identifier
1417907940
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
Legal business name
LPCH MEDICAL GROUP DIV OF LUCILE
Doing business as
Lucile Salter Packard Children's Hospital at Stanford
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 498-6762
NPI assigned
May 12, 2006
Last updated
Aug 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Dana Jean Haering
Title
Cfo
Phone
(650) 721-2222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Children's Hospital 282NC2000X Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

4700 Bohannon Dr
MC 5530
Menlo Park, CA 94025-1031

Other names 1

  • Lucile Salter Packard Children's Hospital at Stanford Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000232 CA Part B Supplier - Clinic/Group Practice 0840298543 Receives reassigned benefits from 3,863 practitioners
Practice locations: Palo Alto, CA

National Provider Directory

National Provider Directory

Locations (25 of 216)

985 Atlantic Ave
Ste 250
Alameda, CA 94501
Phone (510) 263-3300

3700 Sunset Ln
Ste 6
Antioch, CA 94509
Phone (925) 755-8500

3351 El Camino Real
Atherton, CA 94027
Phone (303) 570-9181

20126 Stanton Ave
Ste 200
Castro Valley, CA 94546
Phone (510) 881-4210

9000 Crow Canyon Rd
Ste S220
Danville, CA 94506

11875 Dublin Blvd
#B125
Dublin, CA 94568

6121 Hollis St
Ste 900
Emeryville, CA 94608
Phone (510) 974-2800

5030 Business Center Dr
Ste 230
Fairfield, CA 94534
Phone (707) 863-8190

7130 N Millbrook Ave
Ste 131
Fresno, CA 93720

225 Cabrillo Hwy S
Ste 100A
Half Moon Bay, CA 94019
Phone (650) 712-7330

1134 Murrieta Blvd
#A
Livermore, CA 94550

1134 Murrieta Blvd
Ste A
Livermore, CA 94550
Phone (925) 449-7795

300 Pasteur Dr
Los Angeles, CA 90074

14601 S Bascom Ave
Ste 112
Los Gatos, CA 95032

14651 S Bascom Ave
Ste 110
Los Gatos, CA 95032
Phone (408) 356-8681

14777 Los Gatos Blvd
Los Gatos, CA 95032

15425 Los Gatos Blvd
Ste 101
Los Gatos, CA 95032
Phone (408) 340-5700

16795 Lark Ave
Los Gatos, CA 95032

16795 Lark Ave
Ste 230
Los Gatos, CA 95032
Phone (408) 395-6837

555 Knowles Dr
Ste 207
Los Gatos, CA 95032
Phone (408) 374-1110

718 University Ave
Los Gatos, CA 95032
Phone (408) 354-2114

777 Knowles Dr
Los Gatos, CA 95032

9300 Valley Childrens Pl
#14
Madera, CA 93636
Phone (559) 353-5550

1300 Crane St
#5804
Menlo Park, CA 94025

4700 Bohannon Dr
#5530
Menlo Park, CA 94025

Practitioners & affiliated clinicians

Practitioners 4,404

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 4,404

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1417907940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BOHANNON DR",
            "address_2": "MC 5530",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-498-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LPCH MEDICAL GROUP DIV OF LUCILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "HAERING",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "650-721-2222"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucile Salter Packard Children's Hospital at Stanford",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lucile Salter Packard Children's Hospital at Stanford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.