MJV Health Care Corp

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

050000346 Issued in CA

Legal business name

MJV HEALTH CARE CORP

Doing business as

DBA - Our Lady of Fatima Childrens Home

Practice address

981 Gill Ave
Port Hueneme, CA 93041

Phone

(805) 487-7953

Fax

(805) 487-9757

NPI assigned

Feb 15, 2006

Last updated

Nov 14, 2008By 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

Norma A. Velasco

Title

Asst. Administrator

Phone

(805) 487-9757

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DBA - Our Lady of Fatima Childrens Home Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710951652. Details of each certification follow.

• CCN 05G849 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G849

Legal name

Our Lady of Fatima Childrens Home

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 14, 1995

Last certification

May 14, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

981 Gill Avenue
Port Hueneme, CA 93041

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1710951652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 GILL AVE",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "93041",
            "telephone_number": "805-487-7953",
            "fax_number": "805-487-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 GILL AVE",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "93041",
            "telephone_number": "805-487-7953",
            "fax_number": "805-487-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJV HEALTH CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "VELASCO",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ASST. ADMINISTRATOR",
        "authorized_official_telephone_number": "805-487-9757"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "050000346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60654",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA - Our Lady of Fatima Childrens Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Roberto Martinez, I.D.C.
• Norma Martinez
• Deana Medina
• Medstat Inc
• Karryn Messmer
• Alorah Michelle Molina
• Theresa Denise Moore, ED.D., LCPC
• Ramin Moravveji, DDS
• Kristal Marie Moreno
• Broc Allan Mushet, D.D.S.

• Intellectual Disabilities Intermediate Care Facility in Port Hueneme, CA
• Providers in Port Hueneme, 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 Nov 14, 2008; 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.