NPIMap

Organization Active NPI

Pacifica of the Valley Corporation

Doing business as Pacific Hospital of the Valley

  • Skilled Nursing Facility
  • Sun Valley, CA
National Provider Identifier
1891857389
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PACIFICA OF THE VALLEY CORPORATION
Doing business as
Pacific Hospital of the Valley
Practice address
9449 San Fernando Road
Sun Valley, CA 91352
Phone
(818) 767-3310
Fax
(818) 252-2291
NPI assigned
Dec 14, 2006
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PACIFICA OF THE VALLEY CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 930000148 CA
Skilled Nursing Facility 314000000X NU 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 1

IdentifierTypeStateIssuer
LTC 55217GMedicaidCA

Other names 1

  • Pacific 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
Practice locations: Sun Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891857389. Details of each certification follow.

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 with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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 · All quality measures
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
Tax ID family
Pacifica Em Spec Physic15 organizations share this tax ID, including this one
Part of
Pacifica Em Spec Physic

Other organizations with this tax ID 14

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

View all 14

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 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pacifica Hospital of the ValleySun Valley, CA, CCN 050378 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 14, 2011

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1891857389",
    "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": "YES",
        "parent_organization_legal_business_name": "PACIFICA OF THE VALLEY CORPORATION",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "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": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC 55217G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Hospital of the Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific 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.