NPIMap

Organization Active NPI

Veterans Home of California - Chula Vista

  • Skilled Nursing Facility
  • Chula Vista, CA
National Provider Identifier
1790771194
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
170000836 Issued in CA
Legal business name
VETERANS HOME OF CALIFORNIA - CHULA VISTA
Practice address
700 E Naples CT
Chula Vista, CA 91911-6821
Phone
(619) 482-6010
Fax
(619) 205-1110
NPI assigned
Sep 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Authorized official

Name
Mr. Richard M. Thomas
Title
Acting Administrator
Phone
(619) 482-6037

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 374601005 CA
Skilled Nursing Facility 314000000X 170000836 CA Primary

Addresses

Primary practice location

700 E Naples CT
Chula Vista, CA 91911-6821

Mailing address

700 E Naples CT
Chula Vista, CA 91911-6821
Phone (619) 482-6010

Other identifiers 2

IdentifierTypeStateIssuer
LTC55795FMedicaidCA
DD4357OtherCARAILROAD MEDICARE

Other names 1

  • California Department of Veterans Affairs Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041227000693 CA Part B Supplier - Clinic/Group Practice 9133187941 Receives reassigned benefits from 7 practitioners
Practice locations: Chula Vista, CA
O20130814000875 CA Part A Provider - Skilled Nursing Facility 9133187941 Practice locations: Chula Vista, CA

Skilled nursing facility certification: CCN 555795

Legal name
VETERANS HOME OF CALIFORNIA-CHULA VISTA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 18, 2002
Last certification
Jan 30, 2025
Beds
180
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
700 E Naples CT
Chula Vista, CA 91911-6821
Nursing home name
VETERANS HOME OF CALIFORNIA - CHULA VISTA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Veterans Home Of California - Chula VistaCCN 555795
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Jul 18, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180110.2 residents per day on average
Penalties (3 years)
1Fines totaling $8,018

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

1227 O St
Rm 402
Sacramento, CA 95814

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul D Wagner Individual Adp of the SNF Jul 2, 2004
Timothy Kreisher Individual Operational/Managerial Control Nov 22, 2024
Adp of the SNF Nov 22, 2024
Jimmy Miller Individual Operational/Managerial Control Sep 8, 2008
Adp of the SNF Sep 8, 2008
Veterans Home of California-Chula Vista Organization, Chula Vista, CA Medical staffing company 5% Or Greater Direct Ownership Interest Apr 1, 2000 100%
Operational/Managerial Control Apr 1, 2000
Adp of the SNF Apr 1, 2000

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1790771194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E NAPLES CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116821",
            "telephone_number": "619-482-6010",
            "fax_number": "619-205-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E NAPLES CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116821",
            "telephone_number": "619-482-6010",
            "fax_number": "619-205-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETERANS HOME OF CALIFORNIA - CHULA VISTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ACTING ADMINISTRATOR",
        "authorized_official_telephone_number": "619-482-6037",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "374601005",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "170000836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55795F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD4357",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Department of Veterans Affairs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.