Soledad Dialysis Center LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

140000657 Issued in CA

Legal business name

SOLEDAD DIALYSIS CENTER LLC

Doing business as

Soledad Dialysis Center

Practice address

901 Los Coches Dr
Soledad, CA 93960-2995

Phone

(831) 678-4310

Fax

(831) 678-4324

NPI assigned

Apr 10, 2006

Organization subpart

No

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

Authorized official

Name

Samuel T. Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Soledad Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Renal Treatment Centers California Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Napa, CA
  • NPI 1366405748

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1558324665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-238-3085",
            "fax_number": "800-268-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LOS COCHES DR",
            "city": "SOLEDAD",
            "state": "CA",
            "postal_code": "939602995",
            "telephone_number": "831-678-4310",
            "fax_number": "831-678-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLEDAD DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-01-18",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "140000657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558324665",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soledad Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Soledad Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yoshi Kameche Smith, PHD
• Julia Faith Snell, R.D., L.D., M.S.
• Soledad Community Health Care District
• Soledad Community Health Care District
• Soledad Community Health Care District
• Soledad Unified School District
• Kenya Sorto, MSW
• Sun Street Centers
• Lisa Tobin, PH.D.
• Hoai-an Ton-Nu, PHARMACIST

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Soledad, CA
• Providers in Soledad, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.