Central Coast Skilled Care, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CENTRAL COAST SKILLED CARE, INC

Doing business as

Lompoc Skilled & Rehab. Center

Practice address

1428 W North Ave
Lompoc, CA 93436-3961

Phone

(805) 735-4010

Fax

(805) 736-4296

NPI assigned

Oct 28, 2005

Last updated

Aug 22, 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

Ronald Woodall

Title

President/Ceo

Phone

(209) 533-3333

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lompoc Skilled & Rehab. Center Doing business as

Locations

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760472872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 OLD WARDS FERRY RD",
            "address_2": "SUITE G",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953707822",
            "telephone_number": "209-533-3333",
            "fax_number": "209-533-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 W NORTH AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934363961",
            "telephone_number": "805-735-4010",
            "fax_number": "805-736-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST SKILLED CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "209-533-3333"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05A420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lompoc Skilled & Rehab. Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jakub Cekovsky, MD
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• Central Coast Medical Group
• Karen Lee Chandler, LMFT
• Justin Kaeen Chang, M.D.
• Charles Golodner Counnseling Group
• Katherine Kaye Chase
• Amanda Marie Chavez

• Skilled Nursing Facility in Lompoc, CA
• Providers in Lompoc, 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 Aug 22, 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.