Southern California Stone Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

930000931 Issued in CA

Legal business name

SOUTHERN CALIFORNIA STONE CENTER

Practice address

5400 Balboa Blvd Ste 111
Encino, CA 91316-5206

Phone

(818) 784-8975

Fax

(818) 784-7467

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Catherine Llavanes

Title

Ceo/ Owner

Phone

(818) 453-6963

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Southern California Stone CenterCCN 05C0001441

Medicare certification status

Terminated Voluntary: merger or closure, Nov 29, 2021From the Provider of Services file

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1831235878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 111",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165206",
            "telephone_number": "814-453-6963",
            "fax_number": "310-695-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 111",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165206",
            "telephone_number": "818-784-8975",
            "fax_number": "818-784-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA STONE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "LLAVANES",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "818-453-6963"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "930000931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Pacific Sleep Lab, Inc.
• South Valley Regional Dialysis Center Inc
• South Valley Senior Care LLC
• Southern California Advanced Diagnostic
• Southern California Allergy
• Southwest Hospice Care, Inc
• Maya Spamer, MS, BCBA
• Emma Jean Sparks
• Lanae Sparks
• Specialty Surgical Center of Encino LP

• Ambulatory Surgical Clinic/Center in Encino, CA
• Providers in Encino, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.