Centerwell Certified Healthcare Corp.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CENTERWELL CERTIFIED HEALTHCARE CORP.

Doing business as

CenterWell Home Health

Practice address

10100 Trinity Pkwy Ste 425
Stockton, CA 95219-7238

Phone

(209) 474-7881

Fax

(209) 474-2958

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

John Nichols

Title

Authorized Signatory

Phone

(209) 474-7881

Specialties & licenses 1

Addresses

Other identifiers 14

Other names 1

• CenterWell Home Health Doing business as

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1962434134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SPRINT PKWY STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 TRINITY PKWY STE 425",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197238",
            "telephone_number": "209-474-7881",
            "fax_number": "209-474-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL CERTIFIED HEALTHCARE CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "209-474-7881"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "058025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "106825033",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "GA0588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "5868461",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "ANC015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "114543",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "9900542",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08025F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "013100P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "564478",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "030000602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "05-8025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-COMMERCIAL NUMBER",
            "identifier": "113414024",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA-BLUE SHIELD",
            "identifier": "ZZZ57312Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CenterWell Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Cen, PHARMD
• Jessica Cendana
• Julianne Stacey Cendana
• Center for Independent Rehabilitative Services
• Center for Sight of Stockton a Medical Corporation
• Central Children's Health
• Central One Mobility
• Central Stockton Medical Clinic
• Central Valley Center for Community Advocacy, Inc.
• Central Valley Diabetes Self Management Program

• Home Health Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.