Shasta Residential Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SHASTA RESIDENTIAL CARE LLC

Practice address

16274 Shasta St
Fountain Valley, CA 92708-1865

Phone

(714) 300-4540

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Kevin Dino Hieu Dinh

Title

Ceo

Phone

(714) 300-4540

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1932801735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16274 SHASTA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081865",
            "telephone_number": "714-300-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16274 SHASTA ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081865",
            "telephone_number": "714-300-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "DINH",
        "authorized_official_first_name": "KEVIN DINO",
        "authorized_official_middle_name": "HIEU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-300-4540"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Shao, L.AC.
• Stephen Marcel Shapiro, M.D.
• Sharaf MD
• Abdulkareem Sharaf, MD
• Sharon Gerstenzang
• Lindsay Kathryn Shaw, M.S.
• Dustin Christopher Shea, PA-C
• Noelle Sheppard, PSY.D.
• Caroline Sydnie Sherrill
• Jane Shibley, M.S., OTR/L

• Assisted Living Facility in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.