NPIMap

Organization Active NPI

C Street Health Associates LLC

  • Skilled Nursing Facility
  • Oxnard, CA
National Provider Identifier
1619976131
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
050000033 Issued in CA
Legal business name
C STREET HEALTH ASSOCIATES LLC
Practice address
1300 N C St
Oxnard, CA 93030-4006
Phone
(805) 983-0305
Fax
(805) 983-2514
NPI assigned
Jul 18, 2005
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
Ms. Soon Burnam
Title
Authorized Agent Officer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 050000033 CA Primary

Addresses

Primary practice location

1300 N C St
Oxnard, CA 93030-4006

Mailing address

1300 N C St
Oxnard, CA 93030-4006
Phone (805) 983-0305

Other identifiers 1

IdentifierTypeStateIssuer
LTC55458GMedicaidCA

Other names 1

  • Glenwood 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
O20031125000839 CA Part A Provider - Skilled Nursing Facility 5597669077 Practice locations: Oxnard, CA

Skilled nursing facility certification: CCN 555458

Legal name
C STREET HEALTH ASSOCIATES LLC
Doing business as
GLENWOOD CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 9, 1991
Last certification
May 30, 2025
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
1300 N C St
Oxnard, CA 93030-4006
Nursing home name
GLENWOOD CARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Glenwood Care CenterCCN 555458
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 9, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9996.2 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
05D0717458Glenwood Care Center1300 North C Street, Oxnard, CA 93030Certificate of waiverJul 27, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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, San Juan Capistrano, CA Corporation, LLC, For-profit Direct Ownership Interest Jan 30, 2006 100%
Timothy Cooley Individual Operational/Managerial Control Feb 18, 2017
Managing Control - Governing BodyAdministrator Feb 18, 2017
Adp of the SNF Feb 18, 2017
Oxnard Investments, LP Organization, San Juan Capistrano, CA Adp of the SNF Nov 1, 2003
The Ensign Group Inc Organization, Mission Viejo, CA Corporation, For-profit 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 Jan 15, 2019
Vinod K Valiveti Individual Operational/Managerial Control Nov 1, 2003
Managing Control - Governing BodyMedical Director Nov 1, 2003
Adp of the SNF Nov 1, 2003
Gayle Fisherseib Organization, Thousand Oaks, CA Operational/Managerial Control Nov 1, 2003
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Soon Burnam Individual Corporate OfficerSecretary C Street Health Associate 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

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1619976131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N C ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930304006",
            "telephone_number": "805-983-0305",
            "fax_number": "805-983-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N C ST",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930304006",
            "telephone_number": "805-983-0305",
            "fax_number": "805-983-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C STREET HEALTH ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "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": "AUTHORIZED AGENT OFFICER",
        "authorized_official_telephone_number": "949-540-1249",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "050000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55458G",
            "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": "Glenwood Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glenwood Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.