NPIMap

Organization Active NPI

South Pacific Rehabilitation Servisec

  • Skilled Nursing Facility
  • Chatsworth, CA
National Provider Identifier
1891148201
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
224200000 Issued in CA
Legal business name
SOUTH PACIFIC REHABILITATION SERVISEC
Practice address
10469 Larwin Ave Unit 4
Chatsworth, CA 91311-0314
Phone
(818) 274-7478
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Authorized official

Name
Teresa Fern Farag, AA DEGREE
Title
Ota/L
Phone
(818) 274-7478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 224200000 CA Primary

Addresses

Primary practice location

10469 Larwin Ave Unit 4
Chatsworth, CA 91311-0314

Mailing address

10469 Larwin Ave 4
Chatsworth, CA 91311
Phone (818) 274-7478

Other identifiers 1

IdentifierTypeStateIssuer
224200000MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
South Pacific6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1891148201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10469 LARWIN AVE 4",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "91311",
            "telephone_number": "818-274-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10469 LARWIN AVE UNIT 4",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913110314",
            "telephone_number": "818-274-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PACIFIC REHABILITATION SERVISEC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "FARAG",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "FERN",
        "authorized_official_title_or_position": "OTA/L",
        "authorized_official_telephone_number": "818-274-7478",
        "authorized_official_credential": "AA DEGREE"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "224200000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224200000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.