NPIMap

Organization Active NPI

Community Bridges

Doing business as Lift Line

  • Non-emergency Medical Transport (VAN)
  • Watsonville, CA
National Provider Identifier
1700098969
Registry record updated Jun 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
COMMUNITY BRIDGES
Doing business as
Lift Line
Practice address
545 Ohlone Parkway
Watsonville, CA 95076-6685
Phone
(831) 688-9663
Fax
(831) 688-8302
NPI assigned
May 3, 2007
Last updated
Jun 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2023

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

Authorized official

Name
Mr. Raymon Cancino
Title
Chief Executive Officer
Phone
(831) 688-8840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

545 Ohlone Parkway
Watsonville, CA 95076-6685

Mailing address

519 Main Street
Watsonville, CA 95076-4356
Phone (831) 688-8840

Other identifiers 2

IdentifierTypeStateIssuer
MTN00367FOtherCAMEDI CAL
MTN0036FOtherCAMEDI CAL

Other names 1

  • Lift Line Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

236 Santa Cruz Ave
Aptos, CA 95003

545 Ohlone Pkwy
Watsonville, CA 95076
Phone (831) 688-9663

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685750400000",
    "number": "1700098969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 MAIN STREET",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764356",
            "telephone_number": "831-688-8840",
            "fax_number": "831-688-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 OHLONE PARKWAY",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950766685",
            "telephone_number": "831-688-9663",
            "fax_number": "831-688-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-06-03",
        "certification_date": "2023-06-03",
        "status": "A",
        "authorized_official_last_name": "CANCINO",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "831-688-8840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "MTN00367F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "MTN0036F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lift Line",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lift Line",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2023; 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.