NPIMap

Organization Active NPI

State of California - Department of Developmental Services

  • General Acute Care Hospital
  • Eldridge, CA
National Provider Identifier
1851344220
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
10000089 Issued in CA
Legal business name
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Practice address
15000 Arnold Drive
Eldridge, CA 95431-1493
Phone
(707) 938-6000
Fax
(707) 938-6940
NPI assigned
May 18, 2006
Last updated
Jan 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Authorized official

Name
Carla Castaneda
Title
Chief Deputy Director
Phone
(916) 654-2282

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 10000089 CA Primary
Nursing Facility/Intermediate Care Facility 313M00000X 10000089 CA
Skilled Nursing Facility 314000000X 10000089 CA
Intellectual Disabilities Intermediate Care Facility 315P00000X 10000089 CA
Pharmacy 333600000X 10000089 CA
Long Term Care Pharmacy 3336L0003X HPE19573 CA
Long Term Care Hospital 282E00000X NU

Addresses

Primary practice location

15000 Arnold Drive
Eldridge, CA 95431-1493

Mailing address

1215 O St # Ms 10-30
Sacramento, CA 95814-5804
Phone (916) 654-3463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081114000496 CA Part B Supplier - Clinic/Group Practice 4082788732 Receives reassigned benefits from 73 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cathedral City, CA; Costa Mesa, CA; Porterville, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851344220. Details of each certification follow.

Hospital certification: CCN 050547

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SONOMA DEVELOPMENTAL CENTER
Certification status
Terminated Voluntary: merger or closure, Dec 31, 2018
Provider type (POS)
Hospital – Short-term
Participating since
Nov 1, 1968
Last certification
Aug 9, 2017
Beds
13
Ownership / control type
State
Facility address
15000 Arnold Drive / P O Box 1493
Eldridge, CA 95431

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
State of California Prison Industry Authority30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1851344220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 O ST # MS 10-30",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958145804",
            "telephone_number": "916-654-3463",
            "fax_number": "916-653-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 ARNOLD DRIVE",
            "city": "ELDRIDGE",
            "state": "CA",
            "postal_code": "954311493",
            "telephone_number": "707-938-6000",
            "fax_number": "707-938-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "CASTANEDA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CHIEF DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "916-654-2282"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "10000089",
            "primary": true
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CA",
            "license": "10000089",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "10000089",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "10000089",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "10000089",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "HPE19573",
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldridge, CA

Sources for this page

Verify at the official NPI Registry.