Active NPI
Pacifica of the Valley Corporation
- General Acute Care Hospital
- Sun Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 930000148
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT30378H | Medicaid | CA | |
| 9747230 | Other | MEDI-CAL PROV ACUTE PIN | |
| 9927230 | Other | MEDI-CAL PROV OUTPATIENT | |
| 2887230 | Other | MEDI-CAL PROV TIC PIN | |
| ZZA2008Z | Other | BLUE SHIELD PROVIDER | |
| 1807230 | Other | MEDI-CAL PROV PSYCH PIN | |
| HST30378H | Medicaid | CA | |
| LTC40005F | Medicaid | CA | |
| LTC70026G | Medicaid | CA | |
| HSM30378H | Medicaid | CA | |
| PHV421380 | Medicaid | CA | |
| 8947230 | Other | MEDI-CAL IP-X-OVER PIN | |
| LTC55217G | Medicaid | CA | |
| ZZT40378H | Medicaid | CA |
Other names 1
- Pacifica Hospital of the Valley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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.
-
- Skilled Nursing Facility
- Sun Valley, CA
- NPI 1891857389
O20060126000701
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pacifica Hospital of the Valley DP SNF
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Dec 31, 1985
- Medicare certification status
- Active
- Certified beds
- 98
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Deborah Martin | Corporate Officer | Apr 16, 2018 | |
| Pacifica of the Valley Corporation | 5% Or Greater Direct Ownership Interest | Jan 14, 2011 | 100% |
| Paul R. Tuft | 5% Or Greater Direct Ownership Interest | Jan 14, 2011 | 100% |
| Corporate Director | Jan 14, 2011 | 100% | |
| Precious Velvet Mayes | Corporate Officer | Apr 16, 2018 | |
| Kathy Busch | Corporate Director | 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.
-
- General Acute Care Hospital
- Sun Valley, CA
- NPI 1548328750
5% Or Greater Direct Ownership Interest
-
- Skilled Nursing Facility
- Sun Valley, CA
- NPI 1891857389
5% Or Greater Direct Ownership Interest
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
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Corporation
- Pacifica of the Valley Organization
- Pacifica Radiology Inc
- Felix Padilla
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.