Cornerstone Living Skills

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

CORNERSTONE LIVING SKILLS

Practice address

4740 Badger Rd
Santa Rosa, CA 95409-2634

Phone

(559) 451-0399

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Nancy Bargmann

Title

Vice President

Phone

(909) 579-3151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Baird House Etal Other name

Tax ID family

Baird House Etal3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Cornerstone Living Skills

  • Intellectual Disabilities Intermediate Care Facility
  • Santa Rosa, CA
  • NPI 1376753376
  NPD tax ID
• Cornerstone Living Skills

  • Intellectual Disabilities Intermediate Care Facility
  • Santa Rosa, CA
  • NPI 1609087238
  NPD tax ID

Locations

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790996320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 W BEECHWOOD AVE",
            "address_2": "STE 106",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 BADGER RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092634",
            "telephone_number": "559-451-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE LIVING SKILLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARGMANN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "909-579-3151"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80066F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baird House Etal",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennie Corella-Nestor
• Kristina Corley
• Christopher Cormier
• Cornerstone Living Skills
• Cornerstone Living Skills
• Glency Sue Marie Senires Corominas, M.D.
• Enrique Corona
• Pablo Sergio Corona, NP-C
• Evelyn Gloria Corrales Bernabe
• Mara Corrales Martinez

• Intellectual Disabilities Intermediate Care Facility in Santa Rosa, CA
• Providers in Santa Rosa, 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 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.