Pasadena Villa, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PASADENA VILLA, INC

Practice address

1811 N Raymond Ave
Pasadena, CA 91103-1840

Phone

(310) 413-8717

Fax

(818) 927-6066

NPI assigned

Nov 5, 2020

Last updated

Nov 5, 2020By 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

Kandice Vergara Williams

Title

Executive Director

Phone

(310) 413-8717

Specialties & licenses 1

Addresses

Other names 1

• Pasadena Villa Senior Living Other name

Electronic endpoints 1

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1720689755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 N RAYMOND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031840",
            "telephone_number": "310-413-8717",
            "fax_number": "818-927-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 N RAYMOND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911031840",
            "telephone_number": "310-413-8717",
            "fax_number": "818-927-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADENA VILLA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "VERGARA WILLIAMS",
        "authorized_official_first_name": "KANDICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-413-8717"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kandice@pasadenavillasl.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1811 N Raymond Ave",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911031840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pasadena Villa Senior Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.