Clinton Village Convalescent Hospital

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

LTC90086F Issued in CA

Legal business name

CLINTON VILLAGE CONVALESCENT HOSPITAL

Practice address

1833 10TH Ave
Oakland, CA 94606-3023

Phone

(510) 536-6510

Fax

(510) 536-4319

NPI assigned

Dec 28, 2007

Organization subpart

No

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

Authorized official

Name

Grace D. Parker

Title

Account Executive

Phone

(510) 537-7088

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1558545384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 10TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063023",
            "telephone_number": "510-536-6510",
            "fax_number": "510-536-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 10TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063023",
            "telephone_number": "510-536-6510",
            "fax_number": "510-536-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON VILLAGE CONVALESCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ACCOUNT EXECUTIVE",
        "authorized_official_telephone_number": "510-537-7088"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "CA",
            "license": "LTC90086F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC90086F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhoda Climenhaga, L.AC.
• Joshua Cline, PTA
• Clinica la Luna Y El Sol Medical Center, Inc
• Clinical Massage Services LLC
• Clinton Village Convalescent Hospital
• Liesl Close, MD
• Kasey Lynn Cloud
• Tammy Lynette Cloud
• Gail Clough
• Stephanie Clowdus

• Long Term Care Hospital in Oakland, CA
• Providers in Oakland, CA by specialty
• Long Term Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.