Sunburst Care Center-Winnetka

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC60908F Issued in CA

Legal business name

SUNBURST CARE CENTER-WINNETKA

Practice address

19815 Arminta St
Winnetka, CA 91306-2339

Phone

(818) 993-3222

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Perry Edward Raso

Title

Secretary Treasurer

Phone

(818) 831-0625

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G265

Legal name

SUNBURST CARE CENTER -WINNETKA

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 14, 1999

Last certification

Nov 14, 2025

Beds

6

Ownership / control type

Other (specify)

Facility address

19815 Arminta Street
Winnetka, CA 91306

Tax ID family

Sunburst Care Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Sunburst Care Center

  • Intellectual Disabilities Intermediate Care Facility
  • North Hills, CA
  • NPI 1811105919
  NPD tax ID
• Sunburst Care Center #3

  • Intellectual Disabilities Intermediate Care Facility
  • North Hills, CA
  • NPI 1356550529
  NPD tax ID

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639387731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19684 LOS ALIMOS ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913111934",
            "telephone_number": "818-831-0625",
            "fax_number": "818-368-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19815 ARMINTA ST",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913062339",
            "telephone_number": "818-993-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBURST CARE CENTER-WINNETKA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RASO",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "SECRETARY TREASURER",
        "authorized_official_telephone_number": "818-831-0625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC60908F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "LTC60908F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kelley Michelle Tapia, LMFT
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• Poppy Widyastuti The, DDS
• Sarah Alexis Thomason

• Intellectual Disabilities Intermediate Care Facility in Winnetka, CA
• Providers in Winnetka, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.