Jha Geriatric Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

960000819 Issued in CA

Legal business name

JHA GERIATRIC SERVICES

Practice address

7150 Tampa Ave
Reseda, CA 91335

Phone

(818) 774-3000

NPI assigned

May 27, 2005

Last updated

Jul 2, 2018By 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

Mary M Forrest

Title

Chief Executive Officer

Phone

(818) 774-3208

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grancell Village Clinic Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Jha Geriatric Services, Inc

  • Clinic/Center
  • Reseda, CA
  • NPI 1831264092

  O20040224001368

  Same enrollment
• Jha Geriatric Services, Inc

  • Physical Therapy Clinic/Center
  • Playa Vista, CA
  • NPI 1902403041

  O20040224001368

  Same enrollment

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1811990377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 TAMPA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913353700",
            "telephone_number": "818-774-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 TAMPA AVE",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "91335",
            "telephone_number": "818-774-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JHA GERIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "818-774-3208"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "960000819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70542F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grancell Village Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Grancell Village Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Jay T. Silverman, D.C. and Alison D. Silverman, D.C.,
• Patricia Jeng
• Jha Chiropractor
• Jha Geriatric Services, Inc
• Jimmy Jie, A.B.O.C.
• Jorge Jimenez Jr.
• Jody Wicks, D.D.S., Inc.
• John Foroutan DDS Inc

• Clinic/Center in Reseda, CA
• Providers in Reseda, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.