NPIMap

Organization Active NPI

Victoria Ventura Healthcare LLC

Doing business as Victoria Care Center

  • Skilled Nursing Facility
  • Ventura, CA
National Provider Identifier
1427057645
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
050000271 Issued in CA
Legal business name
VICTORIA VENTURA HEALTHCARE LLC
Doing business as
Victoria Care Center
Practice address
5445 Everglades St
Ventura, CA 93003-6523
Phone
(805) 642-1736
Fax
(805) 639-3198
NPI assigned
Jul 19, 2005
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 050000271 CA Primary

Addresses

Primary practice location

5445 Everglades St
Ventura, CA 93003-6523

Mailing address

5445 Everglades St
Ventura, CA 93003-6523
Phone (805) 642-1736

Other identifiers 1

IdentifierTypeStateIssuer
LTC55478HMedicaidCA

Other names 1

  • Victoria Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031126000090 CA Part A Provider - Skilled Nursing Facility 5890699383 Practice locations: Ventura, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427057645. Details of each certification follow.

Skilled nursing facility certification: CCN 555478

Legal name
VICTORIA VENTURA HEALTHCARE, LLC
Doing business as
VICTORIA CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 18, 1991
Last certification
Feb 27, 2025
Beds
188
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Oct 24, 2003 in NV
Enrollment address
5445 Everglades St
Ventura, CA 93003-6523
Nursing home name
VICTORIA CARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Victoria Care CenterCCN 555478 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 18, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
188180.7 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0887634Victoria Care Center5445 Everglades St, Ventura, CA 93003Certificate of waiverJun 14, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Flagstone Healthcare Central LLC Organization, Mission Viejo, CA LLC 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
The Ensign Group Inc Organization, Mission Viejo, CA Corporation Indirect Ownership Interest Jan 30, 2006 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Nov 1, 2003
Adam Willits Individual Corporate OfficerSole Manager Oct 30, 2018
Ami Sato Individual Corporate OfficerTreasurer Victoria Ventura Healthca Sep 9, 2024
John Gardner Individual Operational/Managerial ControlAdministrator Nov 1, 2010
Managing Control - Governing BodyAdministrator Nov 1, 2010
Adp of the SNF Nov 1, 2010
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Nov 1, 2003
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Nov 1, 2003
Vinod K Valiveti Individual Operational/Managerial Control Mar 9, 2016
Managing Control - Governing BodyMedical Director Mar 9, 2016
Adp of the SNF Mar 9, 2016
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Nov 1, 2003
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Everglades Health Holdings LLC Organization, San Clemente, CA LLC Adp of the SNF Nov 1, 2003
Jared Cullifer Individual Corporate OfficerPresident Victoria Ventura Healthca Jan 1, 2024
Soon Burnam Individual Corporate OfficerSecretary Victoria Ventura Healthca Jan 30, 2006

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Vinod Kumar Valiveti, M.D.
    • Geriatric Medicine (Internal Medicine) Physician
    • Oxnard, CA
    • NPI 1598714107

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1427057645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 EVERGLADES ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036523",
            "telephone_number": "805-642-1736",
            "fax_number": "805-639-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 EVERGLADES ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036523",
            "telephone_number": "805-642-1736",
            "fax_number": "805-639-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA VENTURA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "050000271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55478H",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Victoria Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Victoria Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.