NPIMap

Organization Active NPI

Victoria Division

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Rancho Cucamonga, CA
National Provider Identifier
1467604835
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
240000762 Issued in CA
Legal business name
VICTORIA DIVISION
Practice address
13342 Victoria St
Rancho Cucamonga, CA 91739-2020
Phone
(909) 899-5046
Fax
(909) 463-2005
NPI assigned
Oct 16, 2008
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MONTE VISTA CHILD CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Miss Deisy Odett Mendoza
Title
Executive Director
Phone
(909) 912-9314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 240000762 CA Primary

Addresses

Primary practice location

13342 Victoria St
Rancho Cucamonga, CA 91739-2020

Mailing address

13342 Victoria St
Rancho Cucamonga, CA 91739-2020
Phone (909) 899-5046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467604835. Details of each certification follow.

  • CCN 55G418 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G418

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VICTORIA DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 31, 2001
Last certification
Nov 19, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
13342 Victoria
Rancho Cucamonga, CA 91739

National Provider Directory

National Provider Directory
Tax ID family
Victoria Division19 organizations share this tax ID, including this one
Part of
Victoria Division

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9140 Monte Vis Ave
Montclair, CA 91763
Phone 6262566010308

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1467604835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13342 VICTORIA ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392020",
            "telephone_number": "909-899-5046",
            "fax_number": "909-463-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13342 VICTORIA ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392020",
            "telephone_number": "909-899-5046",
            "fax_number": "909-463-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA DIVISION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTE VISTA CHILD CARE CENTER",
        "enumeration_date": "2008-10-16",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "DEISY",
        "authorized_official_middle_name": "ODETT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-912-9314",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": "240000762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.