Eden Valley Care Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

070000327 Issued in CA

Legal business name

EDEN VALLEY CARE CENTER

Practice address

612 Main Street
Soledad, CA 93960-2533

Phone

(831) 678-2462

NPI assigned

Apr 6, 2007

Last updated

Jun 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ida Lopez Chan

Title

Chief Executive Officer

Phone

(831) 678-2462

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EDEN VALLEY CARE CENTER Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669594867. Details of each certification follow.

• CCN 555538 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 555538

Legal name

SOLEDAD COMMUNITY HEALTH CARE DISTRICT

Doing business as

EDEN VALLEY CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 15, 1993

Last certification

Jan 22, 2025

Beds

59

Ownership / control type

Other Nonprofit

Organization structure

GovernmentNon-profit

Incorporated

May 1, 1949 in CA

Enrollment address

612 Main St
Soledad, CA 93960-2533

Nursing home name

EDEN VALLEY CARE CENTER

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Soledad Community Health Care District

  dba Eden Valley Care Center

  • Skilled Nursing Facility
  • Soledad, CA
  • NPI 1376567834

  O20120207000847

  Same enrollment

Listed as

Eden Valley Care CenterCCN 555538 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Jan 15, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5948.6 residents per day on average

Penalties (3 years)

3Fines totaling $58,191

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Soledad Community Health Care District2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Soledad Community Health Care District

  dba Women's Health Center

  • Rural Health Clinic/Center
  • Soledad, CA
  • NPI 1316868649
  NPD tax ID

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Courtney Jeanne Barry, CNP

  • Nurse Practitioner
  • San Diego, CA
  • NPI 1952419202
  NPD
• Joyce Marianne Dumdum Beltran

  • Family Medicine Physician
  • Salinas, CA
  • NPI 1073949517
  NPD
• Jaime Eliezer Giron, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Soledad, CA
  • NPI 1346321197
  NPD
• William Khieu, MD

  • Family Medicine Physician
  • Salinas, CA
  • NPI 1942203526
  NPD
• Raymond J Pena, M.D.

  • Family Medicine Physician
  • Reedley, CA
  • NPI 1003836974
  NPD

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Joyce Marianne Dumdum Beltran

  • Family Medicine Physician
  • Salinas, CA
  • NPI 1073949517

  Nursing home

  Care Compare affiliation
• Hoang-Tuan K Pham, DO

  • Hospitalist Physician
  • Monterey, CA
  • NPI 1255383873

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1669594867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 MAIN ST",
            "city": "SOLEDAD",
            "state": "CA",
            "postal_code": "939602533",
            "telephone_number": "831-678-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 MAIN STREET",
            "city": "SOLEDAD",
            "state": "CA",
            "postal_code": "939602533",
            "telephone_number": "831-678-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN VALLEY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "IDA",
        "authorized_official_middle_name": "LOPEZ",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "831-678-2462"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "070000327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55538F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EDEN VALLEY CARE CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "EDEN VALLEY CARE CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kimberly De Leon
• Andres Delgadillo
• Kenya Diaz
• Dong Hoon DO Lee, Inc
• Jonna Carla Sanchez Dunlap
• Eitoku Lawton Inc (Soledad Pharmacy and Wellness Center)
• Randulf Villanueva Erguiza, MS, NP, FNP-BC, NP-C
• Esfandiar Eskandari, PH.D,
• Jose F Espaillat, M.D.
• Joanne Carol Etheridge, LCSW

• Skilled Nursing Facility in Soledad, CA
• Providers in Soledad, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.