Active NPI
Humangood Norcal
Doing business as Plymouth Village
- Skilled Nursing Facility
- Redlands, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 240000189
- Legal business name
- HUMANGOOD NORCAL
- Doing business as
- Plymouth Village
- Practice address
- 819 Salem Dr
Redlands, CA 92373 - Phone
- (909) 793-1233
- Fax
- (909) 798-5504
- NPI assigned
- Oct 26, 2006
- Last updated
- Jun 2, 2025
- 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
- Gwen Vangelisto
- Title
- Director of Accounts Receivable
- Phone
- (949) 463-0893
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 240000189 | CA | Primary |
Addresses
Primary practice location
819 Salem Dr
Redlands, CA 92373
Mailing address
1900 Huntington Dr
Duarte, CA 91010-2694
Phone (818) 247-0420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT059140 | Medicaid | CA |
Other names 1
- Plymouth Village
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100222000713 | CA | Part A Provider - Skilled Nursing Facility | 5890782601 | Practice locations: Redlands, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1982789343. Details of each certification follow.
Skilled nursing facility certification: CCN 055914
- Legal name
- HUMANGOOD NORCAL
- Doing business as
- PLYMOUTH VILLAGE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 29, 1968
- Last certification
- Apr 26, 2024
- Beds
- 48
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Humangood, NorCal
- Organization structure
- Corporation
- Incorporated
- Nov 30, 1955 in CA
- Enrollment address
- 819 Salem Dr
Redlands, CA 92373-8502 - Nursing home name
- PLYMOUTH VILLAGE
- Affiliated entity
- HUMANGOOD
Other NPIs with the same Medicare PAC ID 5
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba The Terraces at Los Altos Health Facility
- Skilled Nursing Facility
- Los Altos, CA
- NPI 1083795595
5890782601
-
dba Valle Verde
- Skilled Nursing Facility
- Santa Barbara, CA
- NPI 1255412763
5890782601
-
dba Piedmont Gardens
- Skilled Nursing Facility
- Oakland, CA
- NPI 1437230943
5890782601
-
dba Terraces of Los Gatos
- Skilled Nursing Facility
- Los Gatos, CA
- NPI 1659356111
5890782601
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Plymouth Village
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 29, 1968
- Medicare certification status
- Active
- Certified beds
- 48
- Chain
- Humangood
National Provider Directory
National Provider Directory- Tax ID family
- Humangood Norcal
Other organizations with this tax ID 8
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Rosewood Retirement Community Bakersfield
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1689675415
-
dba Valle Verde Assisted Living
- Assisted Living Facility
- Santa Barbara, CA
- NPI 1952545071
-
dba The Terraces at Los Altos Health Facility
- Skilled Nursing Facility
- Los Altos, CA
- NPI 1083795595
Locations
900 Salem Dr
Redlands, CA 92373
Phone (562) 761-4388
Ownership & related parties
All disclosed owners & managing parties 26
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 |
|---|---|---|---|
| Victoria Davis | Operational/Managerial Control | Aug 6, 2023 | |
| Adp of the SNF | Aug 6, 2023 | ||
| Michael Harrison | Operational/Managerial Control | Jan 2, 2024 | |
| Adp of the SNF | Jan 2, 2024 | ||
| Joanne Christopherson | Corporate Director | Mar 20, 2025 | |
| Mohamed Nassar | Operational/Managerial Control | Jul 1, 2020 | |
| Adp of the SNF | Jul 1, 2020 | ||
| William J Battison | Corporate Director | May 1, 2016 | |
| Hansen | Adp of the SNF | Mar 27, 2017 | |
| Jessica Lopez | Operational/Managerial Control | Jan 20, 2020 | |
| Alan Griffith | Corporate Director | Jun 30, 2019 | |
| Baker Tilly US LLP | Adp of the SNF | Oct 15, 2024 | |
| Albert W Kelley | Corporate Director | May 1, 2016 | |
| Adp of the SNF | May 1, 2016 | ||
| Washington Federal | Adp of the SNF | Oct 27, 2020 | |
| John H. Cochrane | Corporate Officer | Aug 10, 2009 | |
| Operational/Managerial Control | Aug 10, 2009 | ||
| Adp of the SNF | Aug 10, 2009 | ||
| Brett Drake | Operational/Managerial Control | Oct 14, 2024 | |
| Adp of the SNF | Oct 14, 2024 | ||
| Sharon Roth | Corporate Director | Dec 8, 2018 | |
| Humangood Norcal | 5% Or Greater Direct Ownership Interest | Jan 1, 1967 | 100% |
| Operational/Managerial Control | Jan 1, 1967 | ||
| Adp of the SNF | Jan 1, 1967 | ||
| Michelle M Holmes | Corporate Director | May 1, 2016 | |
| Judith D Baker | Corporate Director | Apr 25, 2012 | |
| Herman Declan Brown | Corporate Director | May 1, 2016 | |
| Bethany J Ghassemi | Corporate Officer | May 21, 2019 | |
| Operational/Managerial Control | May 21, 2019 | ||
| Gwen Vangelisto | Corporate Director | Aug 30, 2021 | |
| Operational/Managerial Control | Aug 30, 2021 | ||
| Adp of the SNF | Aug 30, 2021 | ||
| Humangood Socal | Operational/Managerial Control | Jan 1, 1967 | |
| Adp of the SNF | Jan 1, 1967 | ||
| Daniel Ogus | Corporate Officer | Aug 27, 2009 | |
| Operational/Managerial Control | Oct 17, 1995 | ||
| Andrew McDonald | Corporate Officer | Jan 1, 2020 | |
| Operational/Managerial Control | Jan 1, 2020 | ||
| Adp of the SNF | Jan 1, 2020 | ||
| U.S. Bank | 5% Or Greater Security Interest | Apr 1, 2018 | 34% |
| Adp of the SNF | Apr 1, 2018 | ||
| Humangood | 5% Or Greater Indirect Ownership Interest | May 1, 2016 | 100% |
| Adp of the SNF | Dec 5, 2025 | ||
| Irene Feller | Corporate Director | Jan 26, 2021 |
Owners & managing parties with NPI records 11
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba The Terraces at Los Altos Health Facility
- Skilled Nursing Facility
- Los Altos, CA
- NPI 1083795595
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Valle Verde
- Skilled Nursing Facility
- Santa Barbara, CA
- NPI 1255412763
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Piedmont Gardens
- Skilled Nursing Facility
- Oakland, CA
- NPI 1437230943
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Terraces of Los Gatos
- Skilled Nursing Facility
- Los Gatos, CA
- NPI 1659356111
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Rosewood
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1700967213
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Royal Oaks Manor - Bradbury Oaks
- Skilled Nursing Facility
- Duarte, CA
- NPI 1083689848
Adp of the SNF, Operational/Managerial Control
-
dba Redwood Rehabilitation
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Escondido, CA
- NPI 1366078115
Adp of the SNF, Operational/Managerial Control
-
dba Redwood Terrace Health Center
- Skilled Nursing Facility
- Escondido, CA
- NPI 1477055630
Adp of the SNF, Operational/Managerial Control
-
dba Regents Point - Windcrest
- Skilled Nursing Facility
- Irvine, CA
- NPI 1568437325
Adp of the SNF, Operational/Managerial Control
-
- Internal Medicine Physician
- Duarte, CA
- NPI 1811743131
Adp of the SNF, Operational/Managerial Control
-
- Internal Medicine Physician
- Redlands, CA
- NPI 1346545043
Adp of the SNF, Operational/Managerial Control
All facility ownership & control disclosures 14
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Valle Verde Health Facility | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Mar 31, 1967 Mar 31, 1967 Mar 31, 1967 |
| Royal Oaks Manor - Bradbury Oaks | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Apr 15, 1992 Apr 15, 1992 |
| Regents Point - Windcrest | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Feb 2, 1988 Feb 2, 1988 |
| Rydal Park of Philadelphia Presbytery Homes, Inc. | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jul 1, 2019 Jul 1, 2019 |
| The Terraces of Phoenix | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Oct 1, 2003 Oct 1, 2023 |
| Judson Park Health Center | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
May 16, 2012 May 16, 2012 |
| Piedmont Gardens Health Facility | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jan 1, 1969 Jan 1, 1969 Jan 1, 1969 |
| The Terraces at Los Altos Health Facility | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jan 1, 1967 Jan 1, 1967 Jan 1, 1967 |
| Rosewood Health Facility | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Jan 1, 1977 Jan 1, 1977 Jan 1, 1977 |
| Summitview Rehab and Health Center | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Feb 22, 2022 Feb 22, 2022 |
| The Terraces at San Joaquin Gardens Village | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Sep 26, 2012 Sep 26, 2012 |
| The Terraces of Boise | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Dec 21, 2016 Dec 21, 2016 |
| The Terraces of Los Gatos | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control Adp of the SNF |
Mar 12, 1993 Mar 12, 1993 Mar 12, 1993 |
| Redwood Terrace Health Center | Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Feb 2, 1988 Feb 2, 1988 |
Owned or controlled facilities with NPI records 14
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba The Terraces at San Joaquin Gardens Village
- Skilled Nursing Facility
- Fresno, CA
- NPI 1134480817
Adp of the SNF, Operational/Managerial Control
-
dba The Terraces at Los Altos Health Facility
- Skilled Nursing Facility
- Los Altos, CA
- NPI 1083795595
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Valle Verde
- Skilled Nursing Facility
- Santa Barbara, CA
- NPI 1255412763
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Piedmont Gardens
- Skilled Nursing Facility
- Oakland, CA
- NPI 1437230943
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Terraces of Los Gatos
- Skilled Nursing Facility
- Los Gatos, CA
- NPI 1659356111
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Rosewood
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1700967213
5% Or Greater Direct Ownership Interest, Adp of the SNF, Operational/Managerial Control
-
dba Royal Oaks Manor - Bradbury Oaks
- Skilled Nursing Facility
- Duarte, CA
- NPI 1083689848
Adp of the SNF, Operational/Managerial Control
-
dba Redwood Terrace Health Center
- Skilled Nursing Facility
- Escondido, CA
- NPI 1477055630
Adp of the SNF, Operational/Managerial Control
-
dba Regents Point - Windcrest
- Skilled Nursing Facility
- Irvine, CA
- NPI 1568437325
Adp of the SNF, Operational/Managerial Control
-
- Skilled Nursing Facility
- Phoenix, AZ
- NPI 1619058120
Adp of the SNF, Operational/Managerial Control
-
dba The Terraces of Boise
- Skilled Nursing Facility
- Boise, ID
- NPI 1407239973
Adp of the SNF, Operational/Managerial Control
-
dba Rydal Park Medical Center
- Skilled Nursing Facility
- Jenkintown, PA
- NPI 1184619736
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 16
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba The Terraces at San Joaquin Gardens Village
- Skilled Nursing Facility
- Fresno, CA
- NPI 1134480817
Humangood, Humangood Norcal
-
dba The Terraces at Los Altos Health Facility
- Skilled Nursing Facility
- Los Altos, CA
- NPI 1083795595
Humangood Norcal, Humangood Socal
-
dba Valle Verde
- Skilled Nursing Facility
- Santa Barbara, CA
- NPI 1255412763
Humangood, Humangood Norcal, Humangood Socal
-
dba Piedmont Gardens
- Skilled Nursing Facility
- Oakland, CA
- NPI 1437230943
Humangood Norcal, Humangood Socal
-
dba Terraces of Los Gatos
- Skilled Nursing Facility
- Los Gatos, CA
- NPI 1659356111
Humangood, Humangood Norcal, Humangood Socal
-
dba Rosewood
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1700967213
Humangood, Humangood Norcal, Humangood Socal
-
dba Royal Oaks Manor - Bradbury Oaks
- Skilled Nursing Facility
- Duarte, CA
- NPI 1083689848
Humangood, Humangood Norcal, Humangood Socal
-
dba Redwood Terrace Health Center
- Skilled Nursing Facility
- Escondido, CA
- NPI 1477055630
Humangood, Humangood Norcal, Humangood Socal
-
dba Regents Point - Windcrest
- Skilled Nursing Facility
- Irvine, CA
- NPI 1568437325
Humangood, Humangood Norcal, Humangood Socal
-
dba Village at Hillside
- Skilled Nursing Facility
- McMinnville, OR
- NPI 1730889072
Humangood
-
- Skilled Nursing Facility
- Phoenix, AZ
- NPI 1619058120
Humangood, Humangood Norcal
-
dba The Terraces of Boise
- Skilled Nursing Facility
- Boise, ID
- NPI 1407239973
Humangood, Humangood Norcal
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1161820800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748822400000",
"number": "1982789343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 HUNTINGTON DR",
"city": "DUARTE",
"state": "CA",
"postal_code": "910102694",
"telephone_number": "818-247-0420",
"fax_number": "949-528-2434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 SALEM DR",
"city": "REDLANDS",
"state": "CA",
"postal_code": "92373",
"telephone_number": "909-793-1233",
"fax_number": "909-798-5504"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUMANGOOD NORCAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-26",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A",
"authorized_official_last_name": "VANGELISTO",
"authorized_official_first_name": "GWEN",
"authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
"authorized_official_telephone_number": "949-463-0893"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "240000189",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT059140",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Plymouth Village",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Plymouth Village",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.