Organization Active NPI

Pacifica of the Valley Corporation

  • General Acute Care Hospital
  • Sun Valley, CA
National Provider Identifier
1861402935
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
930000148 Issued in CA
Legal business name
PACIFICA OF THE VALLEY CORPORATION
Practice address
9449 San Fernando Road
Sun Valley, CA 91352
Phone
(818) 767-3310
Fax
(818) 252-2291
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Mr. George Watkins
Title
Cfo
Phone
(818) 252-2196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 930000148 CA Primary

Addresses

Primary practice location

9449 San Fernando Road
Sun Valley, CA 91352

Mailing address

9449 San Fernando Road
Sun Valley, CA 91352
Phone (818) 767-3310

Other identifiers 14

IdentifierTypeStateIssuer
ZZT30378HMedicaidCA
9747230OtherMEDI-CAL PROV ACUTE PIN
9927230OtherMEDI-CAL PROV OUTPATIENT
2887230OtherMEDI-CAL PROV TIC PIN
ZZA2008ZOtherBLUE SHIELD PROVIDER
1807230OtherMEDI-CAL PROV PSYCH PIN
HST30378HMedicaidCA
LTC40005FMedicaidCA
LTC70026GMedicaidCA
HSM30378HMedicaidCA
PHV421380MedicaidCA
8947230OtherMEDI-CAL IP-X-OVER PIN
LTC55217GMedicaidCA
ZZT40378HMedicaidCA

Other names 1

  • Pacifica Hospital of the Valley Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126000701 CA Part A Provider - Skilled Nursing Facility 3971517186 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sun Valley, CA

Skilled nursing facility certification: CCN 555217

Legal name
PACIFICA OF THE VALLEY CORPORATION
Doing business as
PACIFICA HOSPITAL OF THE VALLEY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 31, 1985
Last certification
Jan 30, 2025
Beds
98
Ownership / control type
Individual
Organization structure
CorporationProprietary
Incorporated
Dec 3, 1996 in DE
Enrollment address
9449 San Fernando Rd
Sun Valley, CA 91352-1421
Nursing home name
PACIFICA HOSPITAL OF THE VALLEY DP SNF

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pacifica Hospital of the Valley DP SNFCCN 555217
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Dec 31, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9859.1 residents per day on average
Penalties (3 years)
1Fines totaling $60,373

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Deborah Martin Individual Corporate OfficerCfo Apr 16, 2018
Pacifica of the Valley Corporation Organization, Sun Valley, CA Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Jan 14, 2011 100%
Paul R. Tuft Individual 5% Or Greater Direct Ownership Interest Jan 14, 2011 100%
Corporate DirectorExecutive Chairman Jan 14, 2011 100%
Precious Velvet Mayes Individual Corporate Officer Apr 16, 2018
Kathy Busch Individual Corporate DirectorExecutive Director Revenue Cycle Aug 23, 2018
Operational/Managerial Control Aug 23, 2018

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

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": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1861402935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 SAN FERNANDO ROAD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "91352",
            "telephone_number": "818-767-3310",
            "fax_number": "818-252-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 SAN FERNANDO ROAD",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "91352",
            "telephone_number": "818-767-3310",
            "fax_number": "818-252-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA OF THE VALLEY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "818-252-2196",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "930000148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30378H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROV ACUTE PIN",
            "identifier": "9747230",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROV OUTPATIENT",
            "identifier": "9927230",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROV TIC PIN",
            "identifier": "2887230",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER",
            "identifier": "ZZA2008Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROV PSYCH PIN",
            "identifier": "1807230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HST30378H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC40005F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70026G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSM30378H",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHV421380",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL IP-X-OVER PIN",
            "identifier": "8947230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55217G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40378H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Hospital of the Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sun Valley, CA

Sources for this page

Verify at the official NPI Registry.