Palm Drive Nursing & Rehab Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PALM DRIVE NURSING & REHAB CENTER

Practice address

477 Petaluma Ave
Sebastopol, CA 95472-4206

Phone

(707) 823-8511

Fax

(707) 829-4136

NPI assigned

Dec 7, 2007

Organization subpart

Yes

Parent organization

PALM DRIVE HEALTH CARE DISTRICTAs reported in NPPES

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

Authorized official

Name

Mrs. Lori Austin

Title

Coo

Phone

(707) 829-4300

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Palm Drive Hosp Emerg R2 organizations share this tax ID, including this one

Part of

Palm Drive Hosp Emerg R

Other organizations with this tax ID 1

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

• Palm Drive Health Care District

  • Medicare Defined Swing Bed Hospital Unit
  • Sebastopol, CA
  • NPI 1588873822
  NPD tax ID

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1760665178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724215",
            "telephone_number": "707-823-8511",
            "fax_number": "707-829-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724206",
            "telephone_number": "707-823-8511",
            "fax_number": "707-829-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM DRIVE NURSING & REHAB CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALM DRIVE HEALTH CARE DISTRICT",
        "enumeration_date": "2007-12-07",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-829-4300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05520K",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Paige
• Palm Drive Health Care District
• Palm Drive Health Care District
• Palm Drive Health Care District
• Palm Drive Health Care District
• Sangdae Park
• Romina Joy Parungao
• Arianna Passaro
• Melissa Joy Patterson, N.D.
• Durga Yahel Pelaez

• Skilled Nursing Facility in Sebastopol, CA
• Providers in Sebastopol, 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 Mar 11, 2008; 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.