California Children Services Special Care Centers
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.05.13 Adventist Health Glendale Rehabilitation Center 01/14/1977 Provisional Los Angeles 1336138403 Glendale Adventist Med Glendale Adventist Med 1509 Wilson Ter (213) 245-1121
Glendale CA 91206-4007
Community Neonatal Intensive 7.13.17 Adventist Health Glendale Care Unit 01/19/1994 Provisional Los Angeles 1336138403 Glendale Adventist Med Glendale Adventist Med 1509 Wilson Ter (213) 245-1121
Glendale CA 91206-4007
7.21.2 Adventist Health Glendale Prosthetics and Orthotics Facility 12/14/2004 Full Los Angeles 1336138403 Glendale Adventist Med Glendale Adventist Med 1509 Wilson Ter (213) 245-1121
Glendale CA 91206-4007
Communication Disorders Center 7.35.23 Adventist Health Glendale Type C 11/15/2000 Full Los Angeles 1831188275 Glendale Adventist Med Glendale Adventist Med 1509 Wilson Ter (818) 409-8000
Glendale CA 91206-4007
7.38.14 Adventist Health Glendale HRIF - Community 01/19/1994 Provisional Los Angeles 1336138403 Glendale Adventist Med Glendale Adventist Med 1509 Wilson Ter (213) 245-1121
Glendale CA 91206-4007
7.04.08 Adventist Health White Memorial Cleft Palate Center 07/29/1998 Full Los Angeles 1215927470 White Memorial Med Ctr White Memorial Med Ctr 1720 E Cesar E Chavez Av (323) 268-5000
Los Angeles CA 90033-2481
Community Neonatal Intensive 7.13.87 Adventist Health White Memorial Care Unit 06/07/1983 Full Los Angeles 1215927470 White Memorial Med Ctr White Memorial Med Ctr 1720 E Cesar E Chavez Av (323) 268-5000
Los Angeles CA 90033-2481
Ahmc Anaheim Regional Medical Community Neonatal Intensive Ahmc Anaheim Reg Med 7.13.64 Center Care Unit 08/19/2002 Full Orange 1891938122 Ahmc Anaheim Reg Med Ctr Ctr 1111 W La Palma Avenue (714) 774-1450
Anaheim CA 92801-2804
Community Neonatal Intensive Alta Bates Summit Medical 7.13.54 Alta Bates Summit Medical Center Care Unit 07/29/1996 Conditional Alameda 1639523004 Sutter Bay Hospitals Ce 2450 Ashby Avenue (510) 204-4444
Berkeley CA 94705-2067
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Alta Bates Summit Medical 7.15.17 Alta Bates Summit Medical Center Hemophilia Center 06/09/1986 Conditional Alameda 1639523004 Sutter Bay Hospitals Ce 2450 Ashby Avenue (510) 204-4444
Berkeley CA 94705-2067
Alta Bates Summit Medical 7.17.14 Alta Bates Summit Medical Center Sickle Cell Center 06/09/1986 Provisional Alameda 1639523004 Sutter Bay Hospitals Ce 2450 Ashby Avenue (510) 204-4444
Berkeley CA 94705-2067
Communication Disorders Center Alta Bates Summit Medical 7.35.67 Alta Bates Summit Medical Center Type C 04/26/2004 Full Alameda 1639523004 Sutter Bay Hospitals Ce 2450 Ashby Avenue (510) 204-4444
Berkeley CA 94705-2067
Alta Bates Summit Medical 7.38.32 Alta Bates Summit Medical Center HRIF - Community 07/29/2000 Conditional Alameda 1639523004 Sutter Bay Hospitals Ce 2450 Ashby Avenue (510) 204-4444
Berkeley CA 94705-2067
American Hearing Aid Center of TheCommunication Disorders Center 7.33.130 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 6367 Alvarado Ct (760) 449-5391
Suite 101
San Diego CA 92120-4914
American Hearing Aid Center of TheCommunication Disorders Center 7.33.131 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 1820 Marron Road (760) 434-0125
Suite 102
Carlsbad CA 92008-1177
American Hearing Aid Center of TheCommunication Disorders Center 7.33.132 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 9340 Clairemont Mesa Blv (858) 278-9911
Suite D
San Diego CA 92123-1224
American Hearing Aid Center of TheCommunication Disorders Center 7.33.133 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 1767 E Main Street (619) 440-6516
El Cajon CA 92021-5219
American Hearing Aid Center of TheCommunication Disorders Center 7.33.134 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 330 W Felicita Avenue (760) 489-1323
Suite A4
Escondido CA 92025-6531
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
American Hearing Aid Center of TheCommunication Disorders Center 7.33.135 South Bay, Inc Type A 03/30/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 5565 Grossmont Center Drive (619) 589-5414
Building 3,Suite 153
La Mesa CA 91942-3021
American Hearing Aid Center of TheCommunication Disorders Center 7.33.136 South Bay, Inc Type A 05/16/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 801 Orange Avenue (619) 437-8154
Suite 205
Coronado CA 92118-2663
American Hearing Aid Center of TheCommunication Disorders Center 7.33.137 South Bay, Inc Type A 05/16/2016 Full San Diego 1093091662 American Hearing Aid Center Sonus Sf0024 310 Third Avenue (619) 426-0841
Suite C11
Chula Vista CA 91910-3965
Communication Disorders Center 7.34.01 American Hearing And Balance Type B 02/17/2011 Provisional Los Angeles 1740324508 American Hearing And American Hearing And 6229 W 87th Street (310) 677-1168
Los Angeles CA 90045-3901
Communication Disorders Center 7.33.2 ANDERSEN HEARING SERVICES Type A 09/10/2001 Provisional Kern 1215095674 Andersen, Douglas E Anderseon Hearing Service 1801 21st Street (661) 324-2113
Suite 4
Bakersfield CA 93301-3930
Community Neonatal Intensive 7.13.30 Antelope Valley Hospital Care Unit 01/26/1993 Provisional Los Angeles 1366419517 Antelope Valley District Antelope Valley District 1600 W Avenue (661) 949-5000
J
Lancaster CA 93534-2894
Communication Disorders Center 7.33.34 Arcade Hearing Aid Center Type A 03/08/2004 Provisional Los Angeles 1710993993 Michaels, Matthew D Michaels, Matthew D 1911 Wilshire Boulevard (310) 829-6444
Santa Monica CA 90403-5605
Cystic Fibrosis and Other San 7.11.09 Arrowhead Regional Medical CenterPulmonary Disease Center 03/10/2001 Conditional Bernardino Arrowhead Reg Med Ctr Arrowhead Reg Med Ctr 400 N Pepper Avenue (714) 383-3131
Colton CA 92324-1801
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive San 7.13.52 Arrowhead Regional Medical CenterCare Unit 04/01/2001 Provisional Bernardino Arrowhead Reg Med Ctr Arrowhead Reg Med Ctr 400 N Pepper Avenue (714) 383-3131
Colton CA 92324-1801
San 7.38.34 Arrowhead Regional Medical CenterHRIF - Community 04/01/2001 Provisional Bernardino Arrowhead Reg Med Ctr Arrowhead Reg Med Ctr 400 N Pepper Avenue (714) 383-3131
Colton CA 92324-1801
Asante Rogue Regional Medical Community Neonatal Intensive Rogue Valley Medical 7.13.46 Center Care Unit 09/30/1986 Full 1770587107 Asante Center 2825 E Barnett Road (541) 789-4728
Medford OR 97504-8332
Communication Disorders Center 7.33.138 Ascent Hearing Center Type A 04/28/2016 Full Ventura 1730571332 At2j Enterprises Inc Ascent Hearing Center 1717 Simi Town Center (805) 579-9324
Suite 3 WY
Simi Valley CA 93065-8408
Associated Specialists In Hearing Communication Disorders Center 7.33.3 Disorders And Hearing Aids Type A 07/23/2003 Full Riverside 1891881520 Milner, Floyd E Associated Specialists 4400 Brockton Avenue (909) 778-0181
210
Riverside CA 92501-4005
Communication Disorders Center 7.34.2 Audiology Associates of Redding Type B 10/20/2003 Provisional Shasta 1952466948 McWilliams, Rita M McWilliams, Rita M 3328 Churn Creek Road (530) 221-7380
Suite A
Redding CA 96002-2535
Communication Disorders Center 7.35.4 Audiology Associates Santa Rosa Type C 08/24/1999 Full Sonoma 1447327507 Marincovich, Peter J Marincovich, Peter J 1111 Sonoma Avenue (707) 523-4740
Suite 308
Santa Rosa CA 95405-4820
Community Neonatal Intensive 7.13.73 Bakersfield Memorial Hospital Care Unit 01/01/2004 Full Kern 1467538520 Bakersfield Memorial Greater Bakersfield Memo 420 34th Street (661) 327-4647
Bakersfield CA 93301-2237
9/25/21 6:58 PM Page 4 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Bakersfield Memorial 7.25.36 Bakersfield Memorial Hospital Pediatric Intensive Care Unit 10/19/2016 Provisional Kern 1467538520 Bakersfield Memorial Hospita 420 34th Street (661) 327-4647
Bakersfield CA 93301-2237
7.38.70 Bakersfield Memorial Hospital HRIF - Community 01/01/2004 Full Kern 1467538520 Bakersfield Memorial Greater Bakersfield Memo 420 34th Street (661) 327-4647
Bakersfield CA 93301-2237
San 7.05.41 Ballard Rehabilitation Center Rehabilitation Center 01/27/2007 Provisional Bernardino 1497748081 Vibra Hospital of San Bernar Ballard Rehabilitation Hosp 1760 W 16th Street (909) 473-1275
San Bernardino CA 92411-1160
Communication Disorders Center 7.35.133 Barton Memorial Hospital Type C 09/08/2011 Provisional El Dorado 1508865528 Tahoe Carson Valley Tahoe Carson Valley 2155 S Avenue (530) 544-3430
South Lake Tahoe CA 96150-7038
Communication Disorders Center Balance And Hearing Balance And Hearing 7.35.158 Burbank Audiology Center Type C 01/28/2016 Full Los Angeles 1366489197 Resource Resource 1407 Foothill Boulevard (818) 952-1130
2
La Canada CA 91011-2194
Community Neonatal Intensive 7.13.15 California Hospital Medical Center Care Unit 08/29/2017 Full Los Angeles 1114081056 California Hosp Med Ctr Catholic Healthcare West 1401 S Grand Avenue (213) 748-2411
Los Angeles CA 90015-3010
San 7.02.05 California Pacific Medical Center Cardiac Center 05/10/2016 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
San 7.09.26B California Pacific Medical Center Endocrine Center 06/27/2016 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
Cystic Fibrosis and Other San 7.11.18 California Pacific Medical Center Pulmonary Disease Center 05/10/2016 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
9/25/21 6:58 PM Page 5 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Regional Neonatal Intensive San 7.12.02 California Pacific Medical Center Care Unit 05/10/2016 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
San 7.16.27 California Pacific Medical Center Hematology/Oncology Center 08/20/2004 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
Gastroenterology and Nutrition San 7.23.13 California Pacific Medical Center Center 05/10/2016 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
San 7.25.21 California Pacific Medical Center Pediatric Intensive Care Unit 08/29/2017 Full Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
San 7.37.01 California Pacific Medical Center HRIF - Regional 01/01/1985 Provisional Francisco 1902964109 Sutter West Bay Hospitals Calif Pacific Med Ctr 1101 Van Ness Avenue (415) 600-1400
San Francisco CA 94109-6919
Casa Colina Hospital And Centers 7.05.09 For Healthcare Rehabilitation Center 08/30/1985 Provisional Los Angeles 1518327733 Casa Colina Hospital And Casa Colina Hospital 255 E Bonita Avenue (909) 596-7733
Pomona CA 91767-1923
Casa Colina Hospital And Centers Communication Disorders Center 7.35.32 For Healthcare Type C 04/25/2003 Full Los Angeles 1952777245 Casa Colina Hospital And Casa Colina Hospital 255 E Bonita Avenue (909) 596-7733
Pomona CA 91767-1923
Communication Disorders Center Children's Choice For 7.35.161 Cchat Center Type C 07/12/2018 Full Sacramento 1689055337 Children's Choice For Hearin Hearin 11100 Coloma Road (916) 361-7290
Rancho Cordova CA 95670-2804
7.02.02 Cedars-Sinai Medical Center Cardiac Center 02/22/1982 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.03.07 Cedars-Sinai Medical Center Craniofacial Center 04/15/1999 Provisional Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
9/25/21 6:58 PM Page 6 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.09.20A Cedars-Sinai Medical Center Metabolic Center 07/28/2017 Provisional Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.10.14 Cedars-Sinai Medical Center Renal Center 12/12/1990 Conditional Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
Cystic Fibrosis and Other 7.11.08 Cedars-Sinai Medical Center Pulmonary Disease Center 06/04/1992 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
Regional Neonatal Intensive 7.12.03 Cedars-Sinai Medical Center Care Unit 04/12/2010 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.16.04 Cedars-Sinai Medical Center Hematology/Oncology Center 08/10/2017 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.17.16 Cedars-Sinai Medical Center Sickle Cell Center 08/10/2017 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
Gastroenterology and Nutrition 7.23.26 Cedars-Sinai Medical Center Center 05/21/2018 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.25.15 Cedars-Sinai Medical Center Pediatric Intensive Care Unit 04/04/2005 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
Infectious Diseases and 7.26.15 Cedars-Sinai Medical Center Immunologic Disorders 07/28/2017 Conditional Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.27.08 Cedars-Sinai Medical Center Heart Transplant Center 04/18/1997 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Heart and Lung Transplant 7.31.08 Cedars-Sinai Medical Center Center 03/01/2016 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
7.37.02 Cedars-Sinai Medical Center HRIF - Regional 04/19/2018 Full Los Angeles 1639172372 Cedars-Sinai Medical Ctr Cedars Sinai Med Ctr 8700 Beverly Boulevard (310) 855-5000
Los Angeles CA 90048-1804
Center For Early Intervention On Communication Disorders Center 7.35.98 Deafness Type C 06/20/2005 Full Alameda 1942236633 Center For The Education of Center For The Education 1035 Grayson Street (510) 848-4800
Berkeley CA 94710-2642
Center For Early Intervention On Communication Disorders Center 7.35.156 Deafness Type C 03/20/2015 Full Alameda 1942236633 Center For The Education of Center For Early Interventio 3800 Coolidge Avenue (510) 275-8019
Oakland CA 94602-3311
Community Neonatal Intensive 7.13.14 Centinela Hospital Medical Center Care Unit 05/17/1983 Provisional Los Angeles 1336328244 Prime Hlthcare Centinela LLCCentinela Hosp Med Ctr 555 E Hardy Street (310) 673-4660
Inglewood CA 90301-4011
Central Coast Head And Neck Communication Disorders Center 7.33.46 Surgeons Monterey Type A 07/02/2004 Full Monterey 1255405460 Central Coast Head And Central Coast Head And 1095 Los Palos Drive (831) 422-8798
Salinas CA 93901-3916
Central Coast Head And Neck Communication Disorders Center 7.35.153 Surgeons Ryans Ranch Type C 05/12/2014 Full Monterey 1255405460 Central Coast Head And Central Coast Head And 2 Upper Ragsdale Drive (831) 657-0377
Suite B-270
Monterey CA 93940-7845
Central Coast Head And Neck Communication Disorders Center 7.35.100 Surgeons Salinas Type C 10/03/2005 Full Monterey 1255405460 Central Coast Head And Central Coast Head And 1095 Los Palos Drive (831) 422-8798
Salinas CA 93901-3916
7.02.04 Children's Hospital Los Angeles Cardiac Center 07/28/2017 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
9/25/21 6:58 PM Page 8 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.03.04 Children's Hospital Los Angeles Craniofacial Center 10/16/1973 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.05.08 Children's Hospital Los Angeles Rehabilitation Center 10/02/1984 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Myelomeningocele (Spina Bifida) 7.08.07 Children's Hospital Los Angeles Center 06/14/1979 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.09.03A Children's Hospital Los Angeles Metabolic Center 09/13/2017 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.09.03B Children's Hospital Los Angeles Endocrine Center 08/12/1987 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.10.03 Children's Hospital Los Angeles Renal Center 07/01/1981 Conditional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Cystic Fibrosis and Other 7.11.10 Children's Hospital Los Angeles Pulmonary Disease Center 01/25/2001 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Regional Neonatal Intensive 7.12.07 Children's Hospital Los Angeles Care Unit 04/07/2010 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.15.09 Children's Hospital Los Angeles Hemophilia Center 01/24/1980 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.16.12 Children's Hospital Los Angeles Hematology/Oncology Center 07/01/1979 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (323) 660-2450
Los Angeles CA 90027-6062
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Hematology/Oncology - Bone 7.16.12A Children's Hospital Los Angeles Extremity Center 05/01/1989 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Hematology/Oncology - Neuro- 7.16.12B Children's Hospital Los Angeles Oncology Center 05/01/1989 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.17.08 Children's Hospital Los Angeles Sickle Cell Center 08/16/2017 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.19.02 Children's Hospital Los Angeles Bone Marrow Transplant Center 01/01/1987 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
miscellaneous - Neuromuscular 7.20.35 Children's Hospital Los Angeles Center 10/31/2014 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (323) 660-2450
Los Angeles CA 90027-6062
Gastroenterology and Nutrition 7.23.08 Children's Hospital Los Angeles Center 08/12/1983 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.25.18 Children's Hospital Los Angeles Pediatric Intensive Care Unit 09/10/2007 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Infectious Diseases and 7.26.08 Children's Hospital Los Angeles Immunologic Disorders 08/10/1988 Conditional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.27.6 Children's Hospital Los Angeles Heart Transplant Center 05/12/1997 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
7.28.6 Children's Hospital Los Angeles Liver Transplant Center 02/15/1995 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Neonatal Extra-Corporeal 7.29.10 Children's Hospital Los Angeles Membrane Oxygenation (ECMO) 04/07/2010 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Selective Posterior Rhizotomy 7.30.05 Children's Hospital Los Angeles Center 01/03/1995 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Communication Disorders Center 7.35.33 Children's Hospital Los Angeles Type C 01/11/2001 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (323) 660-2450
Los Angeles CA 90027-6062
7.37.04 Children's Hospital Los Angeles HRIF - Regional 02/08/1990 Provisional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Children's Hospital Los Angeles 7.20.34 Epilepsy miscellaneous 10/31/2014 Full Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (323) 660-2450
Los Angeles CA 90027-6062
Children's Hospital Los Angeles 7.20.08 Rheumatology miscellaneous 03/26/1981 Conditional Los Angeles 1124073366 Childrens Hospital of La Childrens Hospital of La 4650 W Sunset Boulevard (213) 660-2450
Los Angeles CA 90027-6062
Community Neonatal Intensive 7.13.83 Choc Children's At Mission Hospital Care Unit 04/06/2009 Full Orange 1699868398 Childrens Hosp At Childrens Hosp of Orange 27700 Med Center Road (714) 365-2180
5th Fl
Mission Viejo CA 92691-6426
7.25.34 Choc Children's At Mission Hospital Pediatric Intensive Care Unit 03/08/2017 Full Orange 1699868398 Childrens Hosp At Childrens Hosp of Orange 27700 Med Center Road (714) 365-2180
5th Fl
Mission Viejo CA 92691-6426
Choc Children's Main Campus- Childrens Hospital of 7.02.25 Orange Cardiac Center 08/02/2017 Conditional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
9/25/21 6:58 PM Page 11 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Choc Children's Main Campus- Childrens Hospital of 7.03.12 Orange Craniofacial Center 08/02/1980 Provisional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Myelomeningocele (Spina Bifida) Childrens Hospital of 7.08.17 Orange Center 06/02/1993 Conditional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Endocrine/Metabolic (PKU) Childrens Hospital of 7.09A.2 Orange Center 07/07/2006 Full Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Childrens Hospital of 7.09.04B Orange Endocrine Center 02/22/2005 Provisional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- 7.10.17 Orange Renal Center 11/20/1996 Full Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
Choc Children's Main Campus- Cystic Fibrosis and Other Childrens Hospital of 7.11.13 Orange Pulmonary Disease Center 06/01/1982 Conditional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Regional Neonatal Intensive 7.12.23 Orange Care Unit 12/12/1979 Full Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
Choc Children's Main Campus- Childrens Hospital of 7.15.20 Orange Hemophilia Center 06/27/1994 Full Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Childrens Hospital of 7.16.13 Orange Hematology/Oncology Center 12/01/1979 Conditional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Childrens Hospital of 7.17.19 Orange Sickle Cell Center 07/27/2017 Conditional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
9/25/21 6:58 PM Page 12 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Choc Children's Main Campus- Childrens Hospital of 7.19.03 Orange Bone Marrow Transplant Center 03/31/1998 Provisional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- miscellaneous - Neuromuscular Childrens Hospital of 7.20.51 Orange Center 04/09/2019 Full Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Gastroenterology and Nutrition Childrens Hospital of 7.23.18 Orange Center 01/04/2001 Full Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- 7.25.09 Orange Pediatric Intensive Care Unit 11/17/1986 Full Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
Choc Children's Main Campus- Infectious Diseases and 7.26.16 Orange Immunologic Disorders 04/19/1991 Provisional Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
Choc Children's Main Campus- Neonatal Extra-Corporeal 7.29.03 Orange Membrane Oxygenation (ECMO) 05/12/1989 Full Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
Choc Children's Main Campus- Childrens Hospital of 7.36.14 Orange Cochlear Implants 11/09/2018 Full Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- Childrens Hospital of 7.37.07 Orange HRIF - Regional 06/04/2005 Provisional Orange 1811080526 Childrens Hospital of Orange 1201 W La Veta Avenue (714) 997-3000
Orange CA 92868-3874
Choc Children's Main Campus- 7.20.12 Orange Rheumatology miscellaneous 08/01/1983 Conditional Orange 1811080526 Childrens Hosp of Orange Childrens Hosp of Orange 455 S Main Street (714) 997-3000
Orange CA 92868-3835
7.16.15 City of Hope Hematology/Oncology Center 10/29/1979 Full Los Angeles 1114109337 City of Hope Helford City of Hope Helford 1500 Duarte Road (818) 359-8111
Duarte CA 91010-3012
9/25/21 6:58 PM Page 13 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.19.05 City of Hope Bone Marrow Transplant Center 01/01/1987 Provisional Los Angeles 1114109337 City of Hope Helford City of Hope Helford 1500 Duarte Road (818) 359-8111
Duarte CA 91010-3012
7.19.12 City of Hope Bone Marrow Transplant Center 01/01/1987 Provisional Los Angeles 1114109337 City of Hope Helford City of Hope Helford 1500 Duarte Road (818) 359-8111
Duarte CA 91010-3012
Intermediate Neonatal Intensive 7.14.76 Clovis Community Medical Center Care Unit 05/15/2014 Full Fresno 1235303306 Clovis Comm Medical Ctr Clovis Comm Medical Ctr 2755 Herndon Avenue (559) 459-6000
Clovis CA 93611-6801
Community Hospital of San Intermediate Neonatal Intensive San San Bernardino Comm 7.14.54 Bernadino Care Unit 10/19/1994 Provisional Bernardino 1235290818 San Bernardino Comm Hosp Hosp 1500 W 17th Street (714) 887-6333
Sn Bernrdno CA 92411-1203
Community Hospital of San San San Bernardino Comm 7.16.28 Bernadino Hematology/Oncology Center 01/01/2000 Provisional Bernardino 1235290818 San Bernardino Comm Hosp Hosp 1500 W 17th Street (714) 887-6333
Sn Bernrdno CA 92411-1203
Community Hospital of San San San Bernardino Comm 7.15.24 Bernardino Hemophilia Center 01/01/2000 Full Bernardino 1235290818 San Bernardino Comm Hosp Hosp 1500 W 17th Street (714) 887-6333
Sn Bernrdno CA 92411-1203
Community Neonatal Intensive 7.13.56 Community Memorial Hospital Care Unit 01/23/1998 Full Ventura 1215903018 Community Memorial Health Comm Mem Hosp San 147 N Brent Street (805) 652-5011
Ventura CA 93003-2809
7.38.38 Community Memorial Hospital HRIF - Community 01/23/2000 Provisional Ventura 1215903018 Community Memorial Health Comm Mem Hosp San 147 N Brent Street (805) 652-5011
Ventura CA 93003-2809
Community Regional Medical Community Specialty 7.02.31 Center Cardiac Center 06/02/2016 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical Community Specialty 7.03.20 Center Craniofacial Center 11/02/2017 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
9/25/21 6:58 PM Page 14 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Regional Medical Endocrine/Metabolic (PKU) Community Specialty 7.09.39 Center Center 06/02/2016 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical Cystic Fibrosis and Other Community Specialty 7.11.32 Center Pulmonary Disease Center 06/02/2016 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical miscellaneous - Neuromuscular Community Specialty 7.20.43 Center Center 06/02/2016 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical Gastroenterology and Nutrition Community Specialty 7.23.25 Center Center 06/02/2016 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical Community Specialty 7.25.40 Center Pediatric Intensive Care Unit 08/07/2019 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical Community Specialty 7.38.71 Center HRIF - Community 08/01/2009 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Community Regional Medical 7.20.29 Center Burn Center miscellaneous 09/19/2012 Full Fresno 1801060975 Community Regional Community Regional 2823 Fresno Street (559) 459-6000
Fresno CA 93721-1324
Community Regional Medical Community Neonatal Intensive Community Specialty 7.13.49 Center-Fresno Care Unit 08/01/2009 Full Fresno 1104906569 Fresno Community Hospital Surgery 2823 Fresno Street (559) 459-1672
Fresno CA 93721-1324
Communication Disorders Center 7.35.53 Connect Hearing Santa Rosa Type C 01/27/2003 Full Sonoma 1265700942 Connect Hearing Inc Newport Audiology Centers 4725 B Hoen Avenue (707) 542-1154
Suite B
Santa Rosa CA 95405-9405
9/25/21 6:58 PM Page 15 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive 7.13.21 Desert Regional Medical Center Care Unit 11/23/1992 Provisional Riverside 1104856095 Tenet Healthsystem Desert Regional Med Ctr 1150 N Indian Canyon Drive (619) 323-6774
Palm Springs CA 92262-4872
7.38.18 Desert Regional Medical Center HRIF - Community 11/21/2003 Provisional Riverside 1104856095 Tenet Healthsystem Desert Regional Med Ctr 1150 N Indian Canyon Drive (619) 323-6774
Palm Springs CA 92262-4872
Community Neonatal Intensive 7.13.18 Doctors Medical Center Care Unit 08/20/2004 Provisional Stanislaus 1184654923 Doctors Medical Center Doctors Med Ctr Modesto 1441 Florida Avenue
Modesto CA 95350-4418
7.38.15 Doctors Medical Center HRIF - Community 08/20/2004 Conditional Stanislaus 1184654923 Doctors Medical Center Doctors Med Ctr Modesto 1441 Florida Avenue
Modesto CA 95350-4418
Community Neonatal Intensive 7.13.88 Dominican Hospital Care Unit 07/14/1992 Full Santa Cruz Dominican Hosp Catholic Healthcare West 1555 Soquel Drive (408) 476-0220
Santa Cruz CA 95065-1794
Communication Disorders Center 7.35.31 Dr Donald Belt Private Practice Type C 12/01/2001 Full San Benito 1841391026 Belt, Donald A PhD Belt, Donald A PhD 920 Sunnyslope Road (408) 637-1911
Hollister CA 95023-5784
Communication Disorders Center 7.33.102 Ears Hearing Healthcare Type A 10/09/2008 Full Riverside 1093091662 American Hearing Aid Center Ears Hearing Healthcare 81833 Doctor Carreon Blv (960) 775-1113
Unit 1
Indio CA 92201-5590
Community Neonatal Intensive 7.13.51 El Camino Hospital Care Unit 07/01/1997 Conditional Santa Clara 1093712374 El Camino Hosp El Camino Hosp 2500 Grant Road (650) 940-7000
Mountain View CA 94040-4302
Communication Disorders Center 7.35.142 El Centro Regional Medical Center Type C 11/08/2012 Full Imperial 1861409823 El Centro Regional Medical El Centro Regional Medical 1415 Ross Avenue (619) 339-7100
El Centro CA 92243-4306
9/25/21 6:58 PM Page 16 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.34.15 El Dorado Hearing Center Type B 07/23/2004 Full El Dorado 1710917711 Rice, Reginald D Jr MD Rice, Reginald D Jr MD 4300 Golden Center Drive (530) 626-6880
Suite D
Placerville CA 95667-6278
7.04.24 Enloe Medical Center Cleft Palate Center 04/30/1982 Conditional Butte 1417901091 Enloe Medical Center N T Enloe Mem Hosp 1531 Esplanade (530) 332-7300
Chico CA 95926-3310
Communication Disorders Center 7.33.127 Excellent Audiology Type A 11/13/2013 Full Ventura 1164507372 Magnusson, Ronald L Gold Coast Audiology 3003 Loma Vista Road (805) 620-0049
Suite C
Ventura CA 93003-2941
Fountain Valley Regional Hospital Community Neonatal Intensive 7.13.16 And Medical Center Care Unit 03/08/2004 Full Orange Fountain Valley Comm Hos Fountain Valley Comm Hos 17100 Euclid Street
Fountain Vly CA 92708-4004
Fountain Valley Regional Hospital 7.25.31 And Medical Center Pediatric Intensive Care Unit 09/01/2012 Full Orange 1821002007 Fountain Valley Regional Fountain Vly Reg Hospmed 17100 Euclid Street (714) 966-7200
Fountain Valley CA 92708-4004
Fountain Valley Regional Hospital 7.38.13 And Medical Center HRIF - Community 03/08/2004 Full Orange 1821002007 Fountain Valley Regional Fountain Vly Reg Hospmed 17100 Euclid Street (714) 966-7200
Fountain Valley CA 92708-4004
Friedel B Cunningham Aud Communication Disorders Center 7.35.37 Associates Type C 05/04/2001 Full Los Angeles 1760491021 Cunningham, Friedel B Cunningham, Friedel B 18401 Burbank Boulevard (818) 341-5407
Suite 106
Tarzana CA 91356-2871
Community Neonatal Intensive 7.13.53 Garfield Medical Center Care Unit 12/02/1997 Provisional Los Angeles 1730171265 Garfield Medical Center Ahmc Garfield Med Ctr Lp 525 N Garfield Avenue (626) 943-4100
Monterey Park CA 91754-1205
Communication Disorders Center 7.33.87 Gateway Hearing Services Type A 01/24/2005 Provisional Merced 1083634364 Carter, Donald P MD Carter, Donald P MD 3351 M Street (209) 724-0501
Suite 205
Merced CA 95348-2731
9/25/21 6:58 PM Page 17 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive 7.13.61 Glendale Memorial Hospital Care Unit 01/19/2001 Full Los Angeles 1477610640 Catholic Hlthcre W So Ca Glendale Memorial Hosp 1420 S Central Avenue (818) 502-1900
Glendale CA 91204-2508
Community Neonatal Intensive 7.13.03 Good Samaritan Hospital Care Unit 04/19/1990 Provisional Los Angeles 1508859323 Good Samaritan Hosp Good Samaritan Hosp 1225 Wilshire Boulevard (213) 977-2121
Los Angeles CA 90017-1901
Community Neonatal Intensive 7.13.19 Good Samaritan Hospital Care Unit 10/30/2002 Full Santa Clara 1437103777 Good Samaritan Hosp, Lp Good Samaritan Hosp, Lp 2425 Samaritan Drive (408) 559-2011
San Jose CA 95124-3985
7.38.16 Good Samaritan Hospital HRIF - Community 10/30/2002 Full Santa Clara 1437103777 Good Samaritan Hosp, Lp Good Samaritan Hosp, Lp 2425 Samaritan Drive (408) 559-2011
San Jose CA 95124-3985
Grossman Burn Center Central 7.20.45 California miscellaneous 04/04/2017 Provisional Kern 1467538520 Bakersfield Memorial Greater Bakersfield Memo 420 34th Street (661) 327-4647
Bakersfield CA 93301-2237
Grossman Burn Center Southern 7.20.44 California miscellaneous 12/12/2017 Full Los Angeles 1023065729 West Hills Hospital West Hills Reg Med Ctr 7300 Medical Center Drive (702) 855-1022
P.O. Box 7937
West Hills CA 91307-1902
7.21.08 HANGER O & P WEST INC Prosthetics and Orthotics Facility 01/01/2001 Provisional Shasta 1588738462 Hanger O P West Inc Hanger O P West Inc 1477 Lincoln Street (530) 246-3333
Redding CA 96001-2641
7.21.09 HANGER P & O WEST INC Prosthetics and Orthotics Facility 04/28/2009 Provisional Placer 1932273810 Hanger P O West Inc Hanger P O West Inc 1755 Grass Valley Highway (530) 823-3143
Auburn CA 95603-2854
7.02.20 Harbor-UCLA Medical Center Cardiac Center 06/29/2004 Full Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
9/25/21 6:58 PM Page 18 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.03.15 Harbor-UCLA Medical Center Craniofacial Center 01/05/2005 Provisional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.09.21A Harbor-UCLA Medical Center Metabolic Center 03/05/2004 Full Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.09.21B Harbor-UCLA Medical Center Endocrine Center 03/28/1989 Provisional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.10.19 Harbor-UCLA Medical Center Renal Center 12/05/2000 Provisional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
Regional Neonatal Intensive 7.12.08 Harbor-UCLA Medical Center Care Unit 07/03/2004 Full Los Angeles 1497778401 Los Angeles County Harbor La County Harbor UCLA 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.16.24 Harbor-UCLA Medical Center Hematology/Oncology Center 05/01/1995 Full Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.17.18 Harbor-UCLA Medical Center Sickle Cell Center 07/01/2005 Conditional Los Angeles 1497778401 Los Angeles County Harbor La County Harbor UCLA 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
7.25.19 Harbor-UCLA Medical Center Pediatric Intensive Care Unit 07/14/2004 Conditional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
Infectious Diseases and 7.26.14 Harbor-UCLA Medical Center Immunologic Disorders 07/01/2005 Conditional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
Communication Disorders Center 7.35.24 Harbor-UCLA Medical Center Type C 04/16/2004 Full Los Angeles 1427070168 Los Angeles County Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
L4
Torrance CA 90502-2004
9/25/21 6:58 PM Page 19 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.37.12 Harbor-UCLA Medical Center HRIF - Regional 07/03/2004 Conditional Los Angeles 1811919558 Los Angeles Co Harbor UC Harbor-UCLA Medical Ctr 1000 W Carson Street (310) 222-2345
Torrance CA 90502-2004
Healthbridge Children's Hospital 7.05.42 Orange Rehabilitation Center 08/29/2003 Provisional Orange Healthbridge Children's Robert Buckley, RN Et Al 393 S Tustin Street (888) 306-5121
Orange CA 92866-2501
Communication Disorders Center 7.33.95 Hear Again 2 Type A 02/26/2007 Full Kern 1831226083 Wilson, Eleanor L Hear Again 2 5000 California Avenue (661) 323-2601
Suite 203
Bakersfield CA 93309-0711
Communication Disorders Center 7.34.19 Hearbright Type B 08/15/2005 Full Santa Clara 1134218332 Ito, Nobuko M Hearbright An Audiology 2577 Samaritan Drive (408) 358-5093
Suite 755
San Jose CA 95124-4109
Communication Disorders Center 7.35.130 Hearbright Type C 04/15/2011 Full Santa Clara 1134218332 Ito, Nobuko M Hearbright An Audiology 200 Jose Figueres Avenue (408) 937-8900
Suite 280
San Jose CA 95116-1585
Communication Disorders Center 7.35.41 Hear Center Type C 08/25/2001 Full Los Angeles 1831255595 Hear Center Hear Center 301 E Del Mar Boulevard (213) 681-4641
Pasadena CA 91101-2714
Communication Disorders Center San Luis 7.35.106 Hearing Aids And Audiology Type C 11/29/2004 Provisional Obispo 1386778470 Scott, Karen M Scott, Karen M 1985 Johnson Avenue (805) 541-1790
Sn Luis Obisp CA 93401-4131
Communication Disorders Center 7.34.29 Hearing And Balance Center Type B 03/04/2008 Full Sutter 1902916737 Lind, Richard C Ma Lind, Richard C Ma 1007 Live Oak Boulevard (916) 755-4155
Suite A3
Yuba City CA 95991-3454
9/25/21 6:58 PM Page 20 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center San 7.35.60 Hearing And Speech Center Type C 12/16/2002 Full Francisco 1164577433 San Francisco Hearing San Francisco Hearing 1234 Divisadero Street (415) 921-7658
San Francisco CA 94115-3911
Hearing And Speech Health Communication Disorders Center 7.33.139 Services Type A 06/02/2016 Full Los Angeles 1942356027 Hearing Clinic Speech Hearing Speech Health 1700 Alameda Street (909) 397-9247
Pomona CA 91768-1727
Hearing Conservation And Communication Disorders Center 7.35.92 Audiology Services Type C 08/16/2004 Provisional Ventura Comm Disorder Center Comm Disorder Center 1515 K Street
Sacramento CA 95814-4051
Communication Disorders Center Santa 7.35.25 Hearing Consultants of California Type C 10/05/2001 Full Barbara 1508080896 Hearing Consultants of Hearing Consultants of 191 Burton Mesa Boulevard (805) 683-5322
Suite C
Lompoc CA 93436-1400
Communication Disorders Center Santa 7.35.43 Hearing Consultants of California Type C 10/05/2001 Full Barbara 1508080896 Hearing Consultants of Hearing Consultants of 191 Burton Mesa Boulevard (805) 683-5322
Suite C
Lompoc CA 93436-1400
Communication Disorders Center 7.33.22 Hearing Life Type A 08/02/2000 Provisional Fresno 1144255472 Reynolds, Robert B Hearing Dynamics 420 Bullard Avenue (559) 299-3566
Suite 101
Clovis CA 93612-1054
Communication Disorders Center 7.33.141 Hearing Science of Arcadia Type A 12/03/2018 Full Los Angeles 1164559456 Hearing Science of Rancho Hearing Science of Rancho 8263 Grove Avenue (909) 920-9906
Suite 203 Rancho Cucamonga CA 91730- 3107
Communication Disorders Center San 7.33.142 Hearing Science of Chino Type A 12/03/2018 Full Bernardino 1164559456 Hearing Science of Rancho Hearing Science of Rancho 8263 Grove Avenue (909) 920-9906
Suite 203 Rancho Cucamonga CA 91730- 3107
9/25/21 6:58 PM Page 21 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center Hearing Science of Daly 7.33.24 Hearing Science of Daly City Type A 07/09/2000 Provisional San Mateo 1932129848 Hearing Science of Daly City 333 Gellert Boulevard (650) 994-3410
Suite 118
Daly City CA 94015-2690
Communication Disorders Center San 7.33.140 Hearing Science of Fontana Type A 11/30/2018 Full Bernardino 1164559456 Hearing Science of Rancho Hearing Science of Rancho 8263 Grove Avenue (909) 920-9906
Suite 203 Rancho Cucamonga CA 91730- 3107
Hearing Science of Rancho Communication Disorders Center San 7.33.25 Cucamonga Type A 08/27/2001 Provisional Bernardino 1164559456 Hearing Science of Rancho Hearing Science of Rancho 8263 Grove Avenue (909) 920-9906
Suite 203 Rancho Cucamonga CA 91730- 3107
Communication Disorders Center 7.33.29 Hearing Solutions Type A 09/17/2001 Provisional Santa Clara 1609957364 Cutting, Julie K Cutting, Julie K 696 E Santa Clara Street
Suite 110
San Jose CA 95112-1911
Communication Disorders Center 7.34.6 Hear Now Oc Type B 04/05/2004 Full Orange 1083709349 Abramson, Maria L Abramson, Maria L 33292 Astoria Street (949) 240-3322
Dana Point CA 92629-1401
Communication Disorders Center 7.35.127 Hear Well Center Type C 05/18/2010 Provisional Los Angeles 1578600086 Martinez, Steve Hear Well Center 3660 Atlantic Avenue (562) 989-8101
Long Beach CA 90807-3418
Communication Disorders Center 7.33.128 High Desert Audiology Type A 03/02/2015 Full Kern 1417994567 Metz, Thomas J Aud Metz, Thomas J 121 S China Lake Boulevard (760) 375-9399
Suite B
Ridgecrest CA 93555-4049
Community Neonatal Intensive 7.13.26 Hoag Hospital Care Unit 11/23/1992 Conditional Orange 1518951300 Hoag Memorial Hospital Hoag Mem Presbyterian 1 Hoag Drive (714) 645-8600
Newport Beach CA 92663-4162
9/25/21 6:58 PM Page 22 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive Hollywood Presbyterian 7.13.67 Hollywood Presbyterian Medical Care Unit 11/07/2005 Provisional Los Angeles 1922033547 Cha Hollywood Medical Med 1300 N Vermont Avenue (323) 644-4452
Los Angeles CA 90027-6005
House Children's Hearing Center of Communication Disorders Center 7.35.150 UCLA Type C 01/29/2014 Full Los Angeles 1619935251 The Regents of The Universit Regentsucla Head Neck 200 Medical Plaza (310) 390-4099
Suite 550
Los Angeles CA 90024
House Children's Hearing Center of 7.36.13 UCLA Cochlear Implants 07/01/2014 Full Los Angeles 1619935251 The Regents of The Universit Regentsucla Head Neck 200 Medical Plaza (310) 390-4099
Suite 550
Los Angeles CA 90024
Community Neonatal Intensive 7.13.91 Huntington Hospital Care Unit 12/02/2010 Full Los Angeles 1407828429 Huntington Memorial Hosp Huntington Memorial Hosp 100 W California Boulevard (213) 681-9303
Pasadena CA 91105-3097
7.38.73 Huntington Hospital HRIF - Community 12/02/2010 Full Los Angeles 1407828429 Huntington Memorial Hosp Huntington Memorial Hosp 100 W California Boulevard (213) 681-9303
Pasadena CA 91105-3097
Communication Disorders Center Santa 7.33.89 Hurdle Hearing And Audiology Type A 09/26/2005 Provisional Barbara 1093871204 Hurdle, Christopher F Hurdle, Christopher F 220 S Palisade Drive (805) 614-4800
Suite 202
Santa Maria CA 93454-8903
John Muir Medical Center Walnut Community Neonatal Intensive 7.13.09 Creek Campus Care Unit 12/21/1990 Conditional Contra Costa 1740215219 John Muir Medical Center John Muir Health 1601 Ygnacio Valley Road (415) 939-3000
Walnut Creek CA 94598-3122
John Muir Medical Center Walnut 7.25.37 Creek Campus Pediatric Intensive Care Unit 05/24/2017 Full Contra Costa 1740215219 John Muir Medical Center John Muir Health 1601 Ygnacio Valley Road (415) 939-3000
Walnut Creek CA 94598-3122
John Muir Medical Center Walnut 7.38.06 Creek Campus HRIF - Community 12/21/1990 Conditional Contra Costa 1740215219 John Muir Medical Center John Muir Health 1601 Ygnacio Valley Road (415) 939-3000
Walnut Creek CA 94598-3122
9/25/21 6:58 PM Page 23 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.35.104 John Tracy Center Type C 05/08/2006 Full Los Angeles 1487959938 John Tracy Clinic John Tracy Clinic 740 E Wardlow Road (562) 426-2257
Long Beach CA 90807-4626
Kaiser Foundation Baldwin Park Community Neonatal Intensive 7.13.106 Medical Center Care Unit 01/29/2019 Full Los Angeles 1477608271 Kaiser Foundation Hosp Kaiser Fndtn Baldwin Prk 1011 Baldwin Park Boulevard (626) 851-5099
Baldwin Park CA 91706-5806
Kaiser Foundation Hospital- Communication Disorders Center 7.35.47 Panorama City Type C 08/05/2003 Provisional Los Angeles 1376698043 Kaiser Foundation Hosp Kaiser Foundation Hosp 13652 Cantara Street (000) 781-2361
Panorama City CA 91402-5423
Kaiser Permanente Anaheim Community Neonatal Intensive 7.13.95 Medical Center Care Unit 02/06/2013 Provisional Orange 1144375056 Kaiser Foundation Hospitals Orange County Lakeview 441 N Lakeview Avenue (714) 998-4400
Anaheim CA 92807-3028
Kaiser Permanente Anaheim 7.38.79 Medical Center HRIF - Community 02/06/2013 Provisional Orange 1144375056 Kaiser Foundation Hospitals Orange County Lakeview 441 N Lakeview Avenue (714) 998-4400
Anaheim CA 92807-3028
Kaiser Permanente Baldwin Park Communication Disorders Center 7.35.107 Medical Center Type C 12/12/2006 Provisional Los Angeles 1477608271 Kaiser Foundation Hosp Kaiser Fndtn-Baldwin Prk 1011 Baldwin Park Boulevard (626) 851-1011
Baldwin Park CA 91706-5806
Kaiser Permanente Downey Community Neonatal Intensive 7.13.78 Medical Center Care Unit 03/22/2007 Full Los Angeles 1518012301 Kaiser Foundation Kaiser Foundation Hospital 9333 Imperial Highway (562) 657-9000
Downey CA 90242-2812
Kaiser Permanente Downey Communication Disorders Center 7.35.72 Medical Center Type C 04/06/2009 Full Los Angeles 1518012301 Kaiser Foundation Kaiser Found Hosp-Bellfl 9333 Imperial Highway (310) 461-3000
Downey CA 90242-2812
Kaiser Permanente Downey 7.38.61 Medical Center HRIF - Community 01/01/2007 Full Los Angeles 1518012301 Kaiser Foundation Kaiser Foundation Hospital 9333 Imperial Highway (562) 657-9000
Downey CA 90242-2812
Kaiser Permanente Fontana Community Neonatal Intensive San Kaiser Foundatn Hosp 7.13.25 Medical Center Care Unit 09/04/1992 Full Bernardino 1356496772 Kaiser Foundation Hospitals Fontana 9961 Sierra Avenue (909) 427-7700
Fontana CA 92335-6720
9/25/21 6:58 PM Page 24 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Fontana San 7.25.32 Medical Center Pediatric Intensive Care Unit 01/31/2014 Full Bernardino 1356496772 Kaiser Foundation Hospitals Kaiser Foundation Hosp 9961 Sierra Avenue (714) 822-3371
Fontana CA 92335-6720
Kaiser Permanente Fontana Communication Disorders Center San Kaiser Foundatn Hosp 7.35.135 Medical Center Type C 08/18/2011 Full Bernardino 1356496772 Kaiser Foundation Hospitals Fontana 9961 Sierra Avenue (909) 427-7700
Fontana CA 92335-6720
Kaiser Permanente Fontana San Kaiser Foundatn Hosp 7.38.21 Medical Center HRIF - Community 09/04/1992 Provisional Bernardino 1356496772 Kaiser Foundation Hospitals Fontana 9961 Sierra Avenue (909) 427-7700
Fontana CA 92335-6720
Kaiser Permanente Hearing CentersCommunication Disorders Center 7.34.33 of Northern California Roseville Type B 11/10/2011 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Hearing CentersCommunication Disorders Center 7.34.31 of Northern California Sacramento Type B 11/10/2011 Full Sacramento 1952476665 Kaiser Foundation Hospital Kaiser Foundation Hosp 2025 Morse Avenue (916) 486-5011
Sacramento CA 95825-2115
Kaiser Permanente Hearing CentersCommunication Disorders Center 7.34.32 of Northern California Sacramento Type B 11/10/2011 Full Sacramento 1952476665 Kaiser Foundation Hospital Kaiser Foundation Hosp 2025 Morse Avenue (916) 486-5011
Sacramento CA 95825-2115
Kaiser Permanente Hearing CentersCommunication Disorders Center 7.34.34 of Northern California Sacramento Type B 11/10/2011 Full Sacramento 1952476665 Kaiser Foundation Hospital Kaiser Foundation Hosp 2025 Morse Avenue (916) 486-5011
Sacramento CA 95825-2115
Kaiser Permanente Los Angeles 7.09.25A Medical Center Metabolic Center 07/27/2017 Provisional Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles Cystic Fibrosis and Other 7.11.33 Medical Center Pulmonary Disease Center 01/03/2017 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hosp 4867 W Sunset Boulevard (213) 667-4811
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles Regional Neonatal Intensive 7.12.27 Medical Center Care Unit 11/13/1986 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
9/25/21 6:58 PM Page 25 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Los Angeles 7.16.17 Medical Center Hematology/Oncology Center 09/15/1982 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles 7.25.27 Medical Center Pediatric Intensive Care Unit 09/21/2017 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles Communication Disorders Center 7.35.45 Medical Center Type C 10/01/2001 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles 7.37.09 Medical Center HRIF - Regional 11/13/1986 Provisional Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hospit 4867 W Sunset Boulevard (323) 783-7897
Los Angeles CA 90027-5969
Kaiser Permanente Los Angeles miscellaneous - Rheumatology 7.20.57 Rheumatology Center 05/04/2021 Full Los Angeles 1821143777 Kaiser Foundation Hosp Kaiser Foundation Hosp 4867 W Sunset Boulevard (213) 667-4811
Los Angeles CA 90027-5969
Kaiser Permanente Oakland 7.20.31 Hypertonicity miscellaneous 01/10/2014 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (415) 653-6121
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.03.17 Medical Center Craniofacial Center 08/15/2002 Provisional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland Myelomeningocele (Spina Bifida) 7.08.13 Medical Center Center 03/27/2001 Provisional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.09.10A Medical Center Metabolic Center 06/03/1980 Provisional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.09.32B Medical Center Endocrine Center 09/28/2009 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
9/25/21 6:58 PM Page 26 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Oakland Cystic Fibrosis and Other 7.11.29 Medical Center Pulmonary Disease Center 07/15/2011 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (415) 653-6121
Oakland CA 94611-5641
Kaiser Permanente Oakland Regional Neonatal Intensive 7.12.17 Medical Center Care Unit 03/26/1979 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.16.25 Medical Center Hematology/Oncology Center 09/09/1997 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.17.21 Medical Center Sickle Cell Center 11/06/1991 Provisional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland miscellaneous - Rheumatology 7.20.32 Medical Center Center 01/10/2014 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (415) 653-6121
Oakland CA 94611-5641
Kaiser Permanente Oakland Gastroenterology and Nutrition 7.23.23 Medical Center Center 01/10/2014 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (415) 653-6121
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.25.26 Medical Center Pediatric Intensive Care Unit 01/01/2001 Full Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland Communication Disorders Center 7.35.46 Medical Center Type C 05/20/2002 Provisional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Oakland 7.37.23 Medical Center HRIF - Regional 03/26/1979 Conditional Alameda 1427123132 Kaiser Foundation Hosp Kaiser Foundation Hosp 275 W Macarthur Boulevard (510) 752-1000
Oakland CA 94611-5641
Kaiser Permanente Panorama City Community Neonatal Intensive 7.13.96 Medical Center Care Unit 04/30/2013 Full Los Angeles 1376698043 Kaiser Foundation Hosp Kaiser Foundation Hosp 13652 Cantara Street (000) 781-2361
Panorama City CA 91402-5423
9/25/21 6:58 PM Page 27 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Panorama City 7.38.80 Medical Center HRIF - Community 04/30/2013 Provisional Los Angeles 1376698043 Kaiser Foundation Hosp Kaiser Foundation Hosp 13652 Cantara Street (000) 781-2361
Panorama City CA 91402-5423
Kaiser Permanente Redwood City Communication Disorders Center 7.35.27 Medical Center Type C 01/14/2002 Full San Mateo 1386714814 Kaiser Foundation Hospitals Kaiser Foundation Hosp 1100 Veterans Boulevard (415) 365-4321
Redwood City CA 94063-2037
Kaiser Permanente Riverside Community Neonatal Intensive 7.13.100 Medical Center Care Unit 03/23/2015 Full Riverside 1306991211 Kaiser Foundation Hosp Kaiser Foundation Hosp 10800 Magnolia Avenue (714) 785-4600
Riverside CA 92505-3000
Kaiser Permanente Roseville 7.02.30 Medical Center Cardiac Center 07/22/2016 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.03.19 Medical Center Craniofacial Center 12/04/2012 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.09.33B Medical Center Endocrine Center 01/04/2012 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville Cystic Fibrosis and Other 7.11.30 Medical Center Pulmonary Disease Center 12/14/2011 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville Regional Neonatal Intensive 7.12.29 Medical Center Care Unit 10/10/2011 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.16.30 Medical Center Hematology/Oncology Center 01/04/2012 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.17.27 Medical Center Sickle Cell Center 03/23/2012 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
9/25/21 6:58 PM Page 28 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Roseville Gastroenterology and Nutrition 7.23.21 Medical Center Center 11/30/2012 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.25.29 Medical Center Pediatric Intensive Care Unit 09/27/2011 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville Communication Disorders Center 7.35.137 Medical Center Type C 11/10/2011 Provisional Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.37.24 Medical Center HRIF - Regional 10/10/2011 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente Roseville 7.20.36 Neuromuscular miscellaneous 10/07/2015 Full Placer 1073811378 Kaiser Foundation Hospitals Kaiser Foundation Hospitals 1600 Eureka Road (916) 784-5727
Roseville CA 95661-3027
Kaiser Permanente San Diego Community Neonatal Intensive Kaiser Foundation Hospital- 7.13.36 Medical Center Care Unit 05/24/1993 Provisional San Diego 1013062769 Kaiser Foundation Hospitals Z 4647 Zion Avenue (619) 528-6295
San Diego CA 92120-2507
Kaiser Permanente San Diego Kaiser Foundation Hospital- 7.38.29 Medical Center HRIF - Community 05/24/2000 Provisional San Diego 1013062769 Kaiser Foundation Hospitals Z 4647 Zion Avenue (619) 528-6295
San Diego CA 92120-2507
Kaiser Permanente San Francisco Community Neonatal Intensive San 7.13.84 Medical Center Care Unit 03/01/1980 Full Francisco 1134299522 Kaiser Foundation Hosp Kaiser Foundation Hosp 2425 Geary Boulevard (415) 829-4000
San Francisco CA 94115-3358
Kaiser Permanente San Francisco San 7.37.10 Medical Center HRIF - Regional 04/27/1980 Provisional Francisco 1134299522 Kaiser Foundation Hosp Kaiser Foundation Hosp 2425 Geary Boulevard (415) 829-4000
San Francisco CA 94115-3358
Kaiser Permanente San Leandro 7.09.35B Medical Center Endocrine Center 08/25/2014 Full Alameda 1649605403 Kaiser Foundation Hospital Kaiser Foundation Hospital 2500 Merced Street (510) 454-1000
San Leandro CA 94577-4201
9/25/21 6:58 PM Page 29 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente San Leandro Community Neonatal Intensive 7.13.85 Medical Center Care Unit 08/25/2014 Full Alameda 1649605403 Kaiser Foundation Hospital Kaiser Foundation Hospital 2500 Merced Street (510) 454-1000
San Leandro CA 94577-4201
Kaiser Permanente San Leandro 7.38.64 Medical Center HRIF - Community 08/25/2014 Full Alameda 1649605403 Kaiser Foundation Hospital Kaiser Foundation Hospital 2500 Merced Street (510) 454-1000
San Leandro CA 94577-4201
Kaiser Permanente Santa Clara 7.09.36B Medical Center Endocrine Center 11/14/2012 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara Cystic Fibrosis and Other 7.11.31 Medical Center Pulmonary Disease Center 01/16/2013 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara Regional Neonatal Intensive 7.12.30 Medical Center Care Unit 01/17/2013 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara 7.16.31 Medical Center Hematology/Oncology Center 01/16/2013 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara Gastroenterology and Nutrition 7.23.20 Medical Center Center 11/14/2012 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara 7.25.30 Medical Center Pediatric Intensive Care Unit 01/02/2013 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
Kaiser Permanente Santa Clara Communication Disorders Center 7.35.113 Medical Center Type C 05/22/2006 Provisional Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051-5173
Kaiser Permanente Santa Clara 7.37.25 Medical Center HRIF - Regional 01/17/2013 Full Santa Clara 1326119967 Kaiser Foundation Hosp Kaiser Foundation Hosp 700 Lawrence Expressway (408) 244-5500
Santa Clara CA 95051
9/25/21 6:58 PM Page 30 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente South Bay Communication Disorders Center 7.35.71 Medical Center Type C 06/07/2004 Provisional Los Angeles 1518012301 Kaiser Foundation Kaiser Foundation Hospital 9333 Imperial Highway (562) 657-9000
Downey CA 90242-2812
Kaiser Permanente South Communication Disorders Center 7.35.138 Sacramento Medical Center Type C 12/15/2012 Provisional Sacramento 1528138088 Kaiser Foundation Hosp Kaiser Foundation Hospital 6600 Bruceville Road (916) 688-2430
Sacramento CA 95823-4671
Kaiser Permanente Vallejo Medical 7.05.02 Center Rehabilitation Center 05/29/1979 Provisional Solano 1366513509 Kaiser Foundation Hospital Kaiser Foundation Hospital 975 Sereno Drive (707) 651-1000
Vallejo CA 94589-2441
Kaiser Permanente Walnut Creek 7.09.34B Medical Center Endocrine Center 10/10/2011 Full Contra Costa 1639244262 Kaiser Foundation Hosp Kaiser Foundation Hosp 1425 S Main Street (925) 295-5888
Walnut Creek CA 94596-5318
Kaiser Permanente Walnut Creek Community Neonatal Intensive 7.13.80 Medical Center Care Unit 03/19/2007 Full Contra Costa 1639244262 Kaiser Foundation Hosp Kaiser Foundation Hosp 1425 S Main Street (510) 295-4000
Walnut Creek CA 94596-5318
Kaiser Permanente Walnut Creek 7.38.62 Medical Center HRIF - Community 03/19/2007 Full Contra Costa 1639244262 Kaiser Foundation Hosp Kaiser Foundation Hosp 1425 S Main Street (510) 295-4000
Walnut Creek CA 94596-5318
Kaiser Permanente West Los Community Neonatal Intensive 7.13.104 Angeles Medical Center Care Unit 08/23/2017 Full Los Angeles 1134274897 Kaiser Found Hosp Wla Kaiser Found Hosp Wla 6041 Cadillac Avenue (323) 857-2201
Los Angeles CA 90034-1702
Kaiser Permanente West Los 7.17.17 Angeles Medical Center Sickle Cell Center 03/30/1990 Full Los Angeles 1134274897 Kaiser Found Hosp Wla Kaiser Found Hosp Wla 6041 Cadillac Avenue (213) 857-2000
Los Angeles CA 90034-1702
Kaiser Permanente West Los Communication Disorders Center 7.35.48 Angeles Medical Center Type C 01/24/2003 Full Los Angeles 1134274897 Kaiser Found Hosp Wla Kaiser Found Hosp Wla 6041 Cadillac Avenue (323) 857-2201
Los Angeles CA 90034-1702
Kaiser Permanente Woodland Hills Community Neonatal Intensive 7.13.43 Medical Center Care Unit 01/05/1994 Full Los Angeles 1295880912 Kaiser Foundation Hosp Kaiser Foundation Hosp 5601 De Soto Avenue (818) 719-2000
Woodland Hills CA 91367-6701
9/25/21 6:58 PM Page 31 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Kaiser Permanente Woodland Hills Communication Disorders Center 7.35.117 Medical Center Type C 07/30/2007 Provisional Los Angeles 1295880912 Kaiser Foundation Hosp Kaiser Foundation Hosp 5601 De Soto Avenue (818) 719-2000
Woodland Hills CA 91367-6701
Kaiser Permanente Wyndham Communication Disorders Center 7.35.139 Medical Office Building Type C 12/15/2011 Full Sacramento 1528138088 Kaiser Foundation Hosp Kaiser Foundation Hospital 6600 Bruceville Road (916) 688-2430
Sacramento CA 95823-4671
Kaweah Health Medical 7.04.29 Kaweah Delta Medical Center Cleft Palate Center 08/30/1984 Provisional Tulare 1588663769 Kaweah Delta Health Care Center 400 W Mineral King Avenue (209) 625-2211
Visalia CA 93291-6237
Myelomeningocele (Spina Bifida) Kaweah Health Medical 7.08.14 Kaweah Delta Medical Center Center 09/05/1985 Conditional Tulare 1588663769 Kaweah Delta Health Care Center 400 W Mineral King Avenue (209) 625-2211
Visalia CA 93291-6237
Community Neonatal Intensive Kaweah Health Medical 7.13.92 Kaweah Delta Medical Center Care Unit 02/13/2012 Full Tulare 1588663769 Kaweah Delta Health Care Center 400 W Mineral King Avenue (209) 625-2211
Visalia CA 93291-6237
Cystic Fibrosis and Other 7.11.27 Keck Hospital of Usc Pulmonary Disease Center 01/01/2000 Conditional Los Angeles 1558394361 Usc University Hosp Usc University Hosp, Inc 1500 San Pablo Street (323) 442-8500
Los Angeles CA 90033-5313
Communication Disorders Center 7.35.146 Keck Hospital of Usc Type C 09/24/2013 Full Los Angeles 1902846306 Usc Care Medical Group Inc Usc Care Medical Group Inc 1500 San Pablo Street (323) 442-8541
Los Angeles CA 90033-5313
7.36.12 Keck Hospital of Usc Cochlear Implants 09/24/2013 Full Los Angeles 1902846306 Usc Care Medical Group Inc Usc Care Medical Group Inc 1500 San Pablo Street (323) 442-8541
Los Angeles CA 90033-5313
Keck Hospital of Usc-Adult Lung Heart and Lung Transplant 7.31.6 Transplant Center Center 05/12/1997 Provisional Los Angeles 1558394361 Usc University Hosp Usc University Hosp, Inc 1500 San Pablo Street (323) 442-8500
Los Angeles CA 90033-5313
Keck Hosptal of Usc-Liver 7.28.10 Transplant Liver Transplant Center 07/12/2019 Full Los Angeles 1558394361 Usc University Hosp Usc University Hosp, Inc 1500 San Pablo Street (323) 442-8500
Los Angeles CA 90033-5313
9/25/21 6:58 PM Page 32 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive 7.13.27 Kern Medical Center Care Unit 03/08/1994 Full Kern 1376623538 Kern Medical Center Kern Medical Center 1700 Mt Vernon Avenue (661) 326-2102
Bakersfield CA 93306-4018
7.38.22 Kern Medical Center HRIF - Community 03/08/1994 Provisional Kern 1376623538 Kern Medical Center Kern Medical Center 1700 Mt Vernon Avenue (661) 326-2102
Bakersfield CA 93306-4018
7.38.56 LAC/MARTIN LUTHER KING HRIF - Community 12/01/2005 Provisional Los Angeles 1962418392 Lacmartin Luther King Lacmartin Luther King 12021 Wilmington Avenue
Los Angeles CA 90059-3019
7.20.37 Lac-Usc Medical Burn Center miscellaneous 08/05/2015 Full Los Angeles 1285647933 Lacusc Medical Center Lacusc Medical Center 1200 N State Street
Los Angeles CA 90033-1029
7.04.36 Lac-Usc Medical Center Cleft Palate Center 01/10/2007 Provisional Los Angeles Lac Usc Med Ctr Gen Hosp Lac Usc Med Ctr Gen Hosp 1200 N State Street
Building 735
Los Angeles CA 90033-1029
Myelomeningocele (Spina Bifida) 7.08.15 Lac-Usc Medical Center Center 01/31/2002 Provisional Los Angeles Lac Usc Med Ctr Gen Hosp Lac Usc Med Ctr Gen Hosp 1200 N State Street
Building 735
Los Angeles CA 90033-1029
7.09.05A Lac-Usc Medical Center Metabolic Center 01/31/2002 Provisional Los Angeles 1790796944 Lacusc Med Ctr Lacusc Med Ctr 1200 N State Street
Los Angeles CA 90033-1029
Regional Neonatal Intensive 7.12.21 Lac-Usc Medical Center Care Unit 02/01/2002 Full Los Angeles 1790796944 Lacusc Med Ctr Lacusc Med Ctr 1200 N State Street
Los Angeles CA 90033-1029
7.16.33 Lac-Usc Medical Center Hematology/Oncology Center 08/05/2015 Full Los Angeles 1285647933 Lacusc Medical Center Lacusc Medical Center 1200 N State Street
Los Angeles CA 90033-1029
9/25/21 6:58 PM Page 33 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.17.13 Lac-Usc Medical Center Sickle Cell Center 09/15/2002 Provisional Los Angeles 1790796944 Lacusc Med Ctr Lacusc Med Ctr 1200 N State Street
Los Angeles CA 90033-1029
7.25.25 Lac-Usc Medical Center Pediatric Intensive Care Unit 03/01/2006 Full Los Angeles 1790796944 Lacusc Med Ctr Lacusc Med Ctr 1200 N State Street
Los Angeles CA 90033-1029
Infectious Diseases and 7.26.13 Lac-Usc Medical Center Immunologic Disorders 07/01/2005 Full Los Angeles 1285647933 Lacusc Medical Center Lacusc Medical Center 1200 N State Street
Los Angeles CA 90033-1029
Communication Disorders Center 7.35.50 Lac-Usc Medical Center Type C 11/15/2000 Full Los Angeles 1467634311 Lacusc Med Ctr Lacusc Med Ctr 1200 N State Street
Los Angeles CA 90033-1029
7.37.21 Lac-Usc Medical Center HRIF - Regional 01/31/2002 Full Los Angeles 1285647933 Lacusc Medical Center Lacusc Medical Center 1200 N State Street
Los Angeles CA 90033-1029
Neonatal Extra-Corporeal San 7.29.11 Loma Linda University Membrane Oxygenation (ECMO) 04/01/1997 Provisional Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.02.26 Hospital Cardiac Center 10/16/1984 Full Bernardino 1699782599 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.03.02 Hospital Craniofacial Center 12/13/1973 Full Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.05.06 Hospital Rehabilitation Center 12/20/1989 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
9/25/21 6:58 PM Page 34 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Loma Linda University Children's Myelomeningocele (Spina Bifida) San 7.08.12 Hospital Center 12/05/1980 Provisional Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.09.40A Hospital Metabolic Center 10/31/2016 Provisional Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.09.07B Hospital Endocrine Center 07/27/2017 Provisional Bernardino 1699782599 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.10.12 Hospital Renal Center 05/11/1987 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's Cystic Fibrosis and Other San 7.11.17 Hospital Pulmonary Disease Center 08/26/1987 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's Regional Neonatal Intensive San 7.12.19 Hospital Care Unit 02/23/1981 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.15.11 Hospital Hemophilia Center 07/31/2017 Conditional Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.16.08 Hospital Hematology/Oncology Center 06/27/1984 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.17.07 Hospital Sickle Cell Center 07/27/2017 Conditional Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
9/25/21 6:58 PM Page 35 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Loma Linda University Children's San 7.19.15 Hospital Bone Marrow Transplant Center 03/27/2009 Provisional Bernardino 1699782599 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's miscellaneous - Neuromuscular San 7.20.50 Hospital Center 02/12/2019 Full Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's Gastroenterology and Nutrition San 7.23.11 Hospital Center 07/31/2017 Provisional Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.25.08 Hospital Pediatric Intensive Care Unit 06/02/1984 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's Infectious Diseases and San 7.26.19 Hospital Immunologic Disorders 01/09/2004 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.27.02 Hospital Heart Transplant Center 09/16/1994 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's Communication Disorders Center San 7.35.73 Hospital Type C 05/24/2004 Provisional Bernardino Loma Linda University Loma Linda University 11370 Anderson Street (800) 326-6223
Suite 2100
Loma Linda CA 92354-3450
Loma Linda University Children's San 7.37.11 Hospital HRIF - Regional 02/23/1981 Full Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.20.26 Hospital Epilepsy miscellaneous 09/29/2011 Conditional Bernardino 1841207750 Loma Linda University Loma Linda University 11234 Anderson Street (714) 796-7311
Loma Linda CA 92354-2804
9/25/21 6:58 PM Page 36 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Loma Linda University Children's San 7.20.49 Hospital Hypertonicity miscellaneous 02/12/2019 Full Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Loma Linda University Children's San 7.20.10 Hospital Rheumatology miscellaneous 06/18/1999 Full Bernardino 1366866345 Loma Linda University Loma Linda University 11234 Anderson Street (909) 651-1422
Suite A
Loma Linda CA 92354-2804
Los Robles Regional Medical Community Neonatal Intensive 7.13.59 Center Care Unit 01/22/2001 Full Ventura 1306890389 Los Robles Hospital Los Robles Hospital 215 W Janss Road (702) 855-1022
Thousand Oaks CA 91360-1899
Los Robles Regional Medical 7.38.42 Center HRIF - Community 01/22/2000 Provisional Ventura 1306890389 Los Robles Hospital Los Robles Hospital 215 W Janss Road (702) 855-1022
Thousand Oaks CA 91360-1899
Lpch Special Care Nursery At Intermediate Neonatal Intensive 7.14.59 Sequoia Hospital Care Unit 12/09/1994 Provisional San Mateo 1235172057 Sequoia Health Svs Sequoia Hosp 170 Alameda (415) 367-5561
De
Redwood City CA 94062-2751
7.36.11 Lucile Packard Children's Hospital Cochlear Implants 08/04/2011 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.02.08 Stanford Cardiac Center 07/31/2017 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.03.03 Stanford Craniofacial Center 03/01/1991 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.09.24A Stanford Metabolic Center 09/26/2001 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
9/25/21 6:58 PM Page 37 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Lucile Packard Children's Hospital 7.09.24B Stanford Endocrine Center 02/23/1998 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.10.10 Stanford Renal Center 07/04/1989 Conditional Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Cystic Fibrosis and Other 7.11.07 Stanford Pulmonary Disease Center 03/01/1991 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Regional Neonatal Intensive 7.12.06 Stanford Care Unit 06/05/1991 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.15.04 Stanford Hemophilia Center 07/31/2017 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.16.10 Stanford Hematology/Oncology Center 03/01/1991 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.17.10 Stanford Sickle Cell Center 03/01/1991 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.19.06 Stanford Bone Marrow Transplant Center 01/01/1993 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital miscellaneous - Neuromuscular 7.20.48 Stanford Center 07/24/2018 Full Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Gastroenterology and Nutrition 7.23.05 Stanford Center 07/31/2017 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
9/25/21 6:58 PM Page 38 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Lucile Packard Children's Hospital 7.25.02 Stanford Pediatric Intensive Care Unit 07/03/1989 Full Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Infectious Diseases and 7.26.03 Stanford Immunologic Disorders 07/31/2017 Conditional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.27.03 Stanford Heart Transplant Center 07/15/1993 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.28.05 Stanford Liver Transplant Center 02/15/1995 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Neonatal Extra-Corporeal 7.29.06 Stanford Membrane Oxygenation (ECMO) 03/27/1989 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Heart and Lung Transplant 7.31.02 Stanford Center 03/28/1994 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Communication Disorders Center 7.35.28 Stanford Type C 01/31/2003 Provisional Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital Communication Disorders Center 7.35.121 Stanford Type C 07/08/2008 Provisional Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Childrens' Hospital 7.36.10 Stanford Cochlear Implants 08/04/2011 Provisional Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.37.13 Stanford HRIF - Regional 06/05/1991 Full Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
9/25/21 6:58 PM Page 39 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Lucile Packard Children's Hospital 7.20.56 Stanford Aerodigestive Center miscellaneous 07/29/2020 Full Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.20.25 Stanford Genetic Skin Disorders miscellaneous 05/12/2014 Provisional Santa Clara 1467442749 Lucile Salter Packard Lucile Salter Packard 725 Welch Road (415) 497-8000
Palo Alto CA 94304-1601
Lucile Packard Children's Hospital 7.20.21 Stanford Rheumatology miscellaneous 01/01/2000 Provisional Santa Clara 1467442749 Lucile Salter Packard Packard Childrens Hospital 725 Welch Road (650) 497-8000
Palo Alto CA 94304-1601
Communication Disorders Center 7.35.140 Mad River Community Hospital Type C 10/28/2011 Full Humboldt 1700092137 Mad River Comm Hospital Mad River Comm Hospital 3800 Janes Road (707) 822-3621
PO Box 1115
Arcata CA 95521-4788
Community Neonatal Intensive Santa Marian Regional Medical 7.13.94 Marian Regional Medical Center Care Unit 07/01/2012 Full Barbara 1760510937 Dignity Health Cen 1400 E Church Street (805) 739-3000
Santa Maria CA 93454-5906
Santa Marian Regional Medical 7.38.78 Marian Regional Medical Center HRIF - Community 07/01/2012 Full Barbara 1760510937 Dignity Health Cen 1400 E Church Street (805) 739-3000
Santa Maria CA 93454-5906
Intermediate Neonatal Intensive 7.14.02 Marin General Hospital Care Unit 09/28/1972 Provisional Marin 1396725677 Marin General Hospital Marin General Hospital 250 Bon Air Road (415) 925-7000
Greenbrae CA 94904-1784
Communication Disorders Center 7.35.51 Marin General Hospital Type C 11/15/2000 Full Marin 1396725677 Marin General Hospital Marinhealth Medical Center 250 Bon Air Road (415) 925-7000
Greenbrae CA 94904-1702
Martin Luther King Jr Outpatient Communication Disorders Center 7.35.49 Center Type C 12/21/2000 Full Los Angeles 1245343052 Martin Luther King, Jr Martin Luther King, Jr 12021 Wilmington Avenue (310) 668-4321
Los Angeles CA 90059-3019
9/25/21 6:58 PM Page 40 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
MCCOY, CAROLYN - HEARING Communication Disorders Center 7.34.3 AND SPEECH SERVICES-LODI Type B 05/22/2003 Provisional San Joaquin 1679653505 McCoy, Carolyn McCoy, Carolyn 1001 Windsor Drive (209) 333-7316
Lodi CA 95240-5129
Intermediate Neonatal Intensive 7.14.09 Memorial Medical Center Care Unit 08/05/2004 Full Stanislaus 1629059746 Memorial Hospit Modesto Memorial Hospit Modesto 1700 Coffee Road (209) 526-4500
Modesto CA 95355-2869
Community Neonatal Intensive Mercy Medical Center 7.13.69 Mercy Medical Center Redding Care Unit 10/23/2002 Provisional Shasta 1477671535 Dignity Health Redding 2175 Rosaline Avenue (530) 225-6102
Redding CA 96001-2509
Community Neonatal Intensive 7.13.07 Mercy San Juan Medical Center Care Unit 12/29/1990 Provisional Sacramento Mercy San Juan Hospital Mercy San Juan Hospital 6501 Coyle Avenue (916) 537-5000
Carmichael CA 95608-0394
7.38.58 Mercy San Juan Medical Center HRIF - Community 04/04/2002 Provisional Sacramento Mercy San Juan Hospital Mercy San Juan Hospital 6501 Coyle Avenue (916) 537-5000
Carmichael CA 95608-0394
Intermediate Neonatal Intensive 7.14.49 Methodist Hospital of Sacramento Care Unit 08/07/2000 Full Sacramento Methodist Hosp of Sacto Methodist Hosp of Sacto 7500 Hospital Drive (916) 391-7440
Sacramento CA 95823-5403
Miller Children's And Women's 7.02.24 Hospital Long Beach Cardiac Center 05/08/1995 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.03.08 Hospital Long Beach Craniofacial Center 03/01/1978 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.05.39 Hospital Long Beach Rehabilitation Center 11/13/1995 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's Myelomeningocele (Spina Bifida) 7.08.19 Hospital Long Beach Center 12/03/1997 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
9/25/21 6:58 PM Page 41 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Miller Children's And Women's Long Beach Memorial 7.09.28A Hospital Long Beach Metabolic Center 05/08/2009 Provisional Los Angeles 1477596583 Medical Memorial Care Miller 2801 Atlantic Avenue (714) 377-6432
Long Beach CA 90806-1701
Miller Children's And Women's 7.09.23B Hospital Long Beach Endocrine Center 04/27/1998 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.10.18 Hospital Long Beach Renal Center 07/14/2000 Conditional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's Cystic Fibrosis and Other 7.11.15 Hospital Long Beach Pulmonary Disease Center 02/09/2001 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's Regional Neonatal Intensive 7.12.05 Hospital Long Beach Care Unit 03/01/1978 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.15.22 Hospital Long Beach Hemophilia Center 01/10/2002 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.16.07 Hospital Long Beach Hematology/Oncology Center 02/01/2001 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.17.20 Hospital Long Beach Sickle Cell Center 02/09/2001 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's Gastroenterology and Nutrition Long Beach Memorial 7.23.12 Hospital Long Beach Center 05/03/1995 Provisional Los Angeles 1477596583 Medical Memorial Care Miller 2801 Atlantic Avenue (714) 377-6432
Long Beach CA 90806-1701
Miller Children's And Women's 7.25.10 Hospital Long Beach Pediatric Intensive Care Unit 05/22/1984 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
9/25/21 6:58 PM Page 42 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Miller Children's And Women's Infectious Diseases and 7.26.12 Hospital Long Beach Immunologic Disorders 02/09/2001 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.37.22 Hospital Long Beach HRIF - Regional 09/02/1978 Provisional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.20.23 Hospital Long Beach Hypertonicity miscellaneous 01/01/2001 Full Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Miller Children's And Women's 7.20.19 Hospital Long Beach Rheumatology miscellaneous 07/28/1998 Conditional Los Angeles 1477596583 Long Beach Mem Med Ctr Miller Children's Hosp 2801 Atlantic Avenue (652) 933-8001
Long Beach CA 90806-1701
Communication Disorders Center Mills-Peninsula Medical 7.35.68 Mills-Peninsula Medical Center Type C 04/16/2004 Full San Mateo 1043670334 Sutter Bay Hospitals Cent 1501 Trousdale Drive (650) 696-5400
Burlingame CA 94010-4506
Community Neonatal Intensive 7.13.76 Natividad Medical Center Care Unit 07/01/2005 Full Monterey 1699979245 County of Monterey Natividad Medical Center 1441 Constitution Boulevard (831) 755-4111
Salinas CA 93906-3100
Communication Disorders Center 7.35.95 Natividad Medical Center Type C 11/11/2004 Full Monterey 1174727143 County of Monterey County of Monterey 1441 Constitution Boulevard (831) 755-4235
Salinas CA 93906-3100
7.38.59 Natividad Medical Center HRIF - Community 01/01/2006 Conditional Monterey County of Monterey Natividad Medical Ctr 1441 Constitution Boulevard (408) 424-2541
Salinas CA 93906-3100
7.38.60 Natividad Medical Center HRIF - Community 07/01/2005 Conditional Monterey 1699979245 County of Monterey Natividad Medical Center 1441 Constitution Boulevard (831) 755-4111
Salinas CA 93906-3100
Newport-Mesa Audiology Balance Communication Disorders Center 7.34.35 And Ear Institute Type B 05/25/2016 Full Orange 1144385998 Newport Mesa Audiology Inc Newport-Mesa Audiology 500 N Newport Boulevard (714) 642-7935
Suite 101
Newport Beach CA 92663-4234
9/25/21 6:58 PM Page 43 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Newport-Mesa Audiology Balance Communication Disorders Center 7.35.160 And Ear Institute Type C 05/25/2016 Full Orange 1144385998 Newport Mesa Audiology Inc Newport-Mesa Audiology 500 N Newport Boulevard (714) 642-7935
Suite 101
Newport Beach CA 92663-4234
Community Neonatal Intensive 7.13.32 Northbay Medical Center Care Unit 05/21/1993 Conditional Solano 1821147786 Northbay Healthcare Group Northbay Medical Ctr 1200 B Gale Wilson Boulevard (707) 429-3600
Fairfield CA 94533-3552
7.38.27 Northbay Medical Center HRIF - Community 05/22/2000 Conditional Solano 1821147786 Northbay Healthcare Group Northbay Medical Ctr 1200 B Gale Wilson Boulevard (707) 429-3600
Fairfield CA 94533-3552
Communication Disorders Center 7.35.103 North Coast Audiology Type C 03/13/2006 Provisional Humboldt 1841291549 Kelly, Julie L Kelly, Julie L 2818 Harris Street (707) 443-4503
Eureka CA 95503-4809
7.05.25 Northridge Hospital Rehabilitation Center 10/01/1986 Provisional Los Angeles Northridge Hosp Found Northridge Hosp Found 18300 Roscoe Boulevard (818) 885-8500
Northridge CA 91325-4105
Community Neonatal Intensive 7.13.40 Northridge Hospital Care Unit 08/19/1993 Provisional Los Angeles Northridge Hosp Found Northridge Hosp Found 18300 Roscoe Boulevard (818) 885-8500
Northridge CA 91325-4105
7.25.28 Northridge Hospital Pediatric Intensive Care Unit 08/06/2010 Full Los Angeles 1417089350 Dignity Health Northridge Hosp Med Cntr 18300 Roscoe Boulevard (818) 885-8500
Northridge CA 91325-4105
Community Neonatal Intensive 7.13.93 O'Connor Hospital Care Unit 02/14/2012 Full Santa Clara 1063406551 Santa Clara Med Ctr O'Connor Hospital 2105 Forest Avenue (408) 885-7200
San Jose CA 95128-1425
7.04.31 Olive View-UCLA Medical Center Cleft Palate Center 02/19/1985 Full Los Angeles 1750305785 Los Angeles Co La Co Olive View-UCLA 14445 Olive View Drive (818) 901-3000
Sylmar CA 91342-1437
9/25/21 6:58 PM Page 44 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive 7.13.90 Olive View-UCLA Medical Center Care Unit 07/01/2010 Full Los Angeles 1417970567 Los Angeles County Olive La County Olive View-UCLA 14445 Olive View Drive (818) 901-3000
Sylmar CA 91342-1437
7.38.05 Olive View-UCLA Medical Center HRIF - Community 10/20/1998 Full Los Angeles 1417970567 Los Angeles County Olive La County Olive View-UCLA 14445 Olive View Drive (818) 901-3000
Sylmar CA 91342-1437
Orange County Global Medical Burn 7.20.22 Center miscellaneous 01/10/2008 Full Orange 1982697678 Wmc Sa Inc Western Medical Center 1001 N Tustin Avenue (714) 953-3610
Santa Ana CA 92705-3577
Orange County Global Medical Community Neonatal Intensive 7.13.63 Center Care Unit 04/29/1986 Provisional Orange Western Medical Center Wmc-Sa, Inc 1001 N Tustin Avenue (714) 953-3610
Santa Ana CA 92705-3577
Orange County Physicians Hearing Communication Disorders Center 7.35.119 Services Type C 11/14/2007 Full Orange 1750324554 Orange County Physicians Orange County Physicians 26726 Crown Valley Parkway (949) 364-4361
Suite 210
Mission Viejo CA 92691-8006
7.03.16 Orthopaedic Institute For Children Craniofacial Center 11/08/1999 Provisional Los Angeles Orthopaedic Hosp Orthopaedic Hosp 2400 S Flower Street (213) 742-1000
Los Angeles CA 90007-2629
Myelomeningocele (Spina Bifida) 7.08.08 Orthopaedic Institute For Children Center 01/16/1987 Conditional Los Angeles Orthopaedic Hosp Orthopaedic Hosp 2400 S Flower Street (213) 742-1000
Los Angeles CA 90007-2629
7.15.13 Orthopaedic Institute For Children Hemophilia Center 06/26/1989 Full Los Angeles Orthopaedic Hosp Orthopaedic Hosp 2400 S Flower Street (213) 742-1000
Los Angeles CA 90007-2629
7.16.16 Orthopaedic Institute For Children Hematology/Oncology Center 01/01/1987 Conditional Los Angeles Orthopaedic Hosp Orthopaedic Hosp 2400 S Flower Street (213) 742-1000
Los Angeles CA 90007-2629
9/25/21 6:58 PM Page 45 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Orthopaedic Institute For Children 7.20.07 Neuromuscular miscellaneous 03/23/1986 Provisional Los Angeles Orthopaedic Hosp Orthopaedic Hosp 2400 S Flower Street (213) 742-1000
Los Angeles CA 90007-2629
Communication Disorders Center San 7.33.77 Pacific Hearing Services Type A 10/15/2004 Full Bernardino 1801986617 Pacific Audiological Pacific Hearing Services 9033 Base Line Road (909) 989-4800
Suite F Rancho Cucamonga CA 91730- 1214
Parkview Community Hospital Community Neonatal Intensive 7.13.71 Medical Center Care Unit 02/02/2006 Full Riverside 1124596382 Doctors Hospital of Doctors Hospital of 3865 Jackson Street (951) 688-2211
Riverside CA 92503-3919
Communication Disorders Center 7.33.70 Petaluma Valley Hearing Services Type A 07/23/2004 Full Sonoma 1811031479 Murphy-Piltch, Michelle Murphy-Piltch, Michelle 106 Lynch Creek Way (707) 762-0103
9aa
Petaluma CA 94954-2356
Communication Disorders Center 7.35.144 Petaluma Valley Hospital Type C 04/09/2013 Full Sonoma 1235162645 Srm Alliance Hosp Svs Petaluma Valley Hosp 400 N McDowell Boulevard (707) 525-5300
Petaluma CA 94954-2339
Communication Disorders Center Santa 7.33.30 Physician's Hearing Service Type A 06/07/2004 Full Barbara 1427382811 Wikholm, Richard P MD Inc Wikholm, Richard P MD Inc 116 S Palisade Drive (805) 614-9250
Suite 206
Santa Maria CA 93454-8906
Community Neonatal Intensive 7.13.57 Pih Health Care Unit 07/02/1997 Full Los Angeles 1043215379 Presbyterian Intercomm Presbyterian Intercomm 12401 Washington Boulevard (310) 698-0811
Whittier CA 90602-1006
Pioneers Memorial Healthcare Community Neonatal Intensive 7.13.109 District Care Unit 10/11/2018 Full Imperial 1073519443 Pioneers Memorial Health Pioneers Memorial Health 207 W Legion Road (760) 351-3333
Brawley CA 92227-7780
Pioneers Memorial Healthcare Intermediate Neonatal Intensive 7.14.81 District Care Unit 10/11/2018 Full Humboldt 1073519443 Pioneers Memorial Health Pioneers Memorial Health 207 W Legion Road (760) 351-3333
Brawley CA 92227-7780
9/25/21 6:58 PM Page 46 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Pomona Valley Hospital Medical Community Neonatal Intensive 7.13.44 Center Care Unit 01/13/2006 Full Los Angeles 1407813660 Pomona Valley Hospital Pomona Valley Hospital 1798 N Garey Avenue (909) 865-9500
Pomona CA 91767-2918
Pomona Valley Hospital Medical 7.38.46 Center HRIF - Community 08/06/2004 Conditional Los Angeles 1407813660 Pomona Valley Hospital Pomona Valley Hospital 1798 N Garey Avenue (909) 865-9500
Pomona CA 91767-2918
Providence Holy Cross Medical Community Neonatal Intensive 7.13.98 Center Care Unit 01/08/2014 Full Los Angeles 1477587632 Providence Health System Providence Holy Cross 15031 Rinaldi Street (818) 365-8057
Mission Hills CA 91345-1207
Providence Holy Cross Medical 7.38.81 Center HRIF - Community 09/24/2014 Full Los Angeles 1477587632 Providence Health System Providence Holy Cross 15031 Rinaldi Street (818) 365-8057
Mission Hills CA 91345-1207
Providence Little Company of Mary Community Neonatal Intensive 7.13.97 Medical Center Care Unit 05/15/2013 Full Los Angeles 1902844988 Providence Health System Providence Little Co of Mary 4101 Torrance Boulevard (310) 540-7676
Torrance CA 90503-4607
Providence Saint John's Health 7.04.06 Center Cleft Palate Center 03/21/1988 Provisional Los Angeles 1124026273 Providence Saint Johns Providence Saint Johns 2121 Santa Monica Boulevard (310) 829-5511
Santa Monica CA 90404-2303
Providence Saint Joseph Medical Community Neonatal Intensive 7.13.58 Center Care Unit 04/08/1998 Provisional Los Angeles 1336173269 Providence St Joseph Med Providence St Joseph Med Buena Vista Alameda Street
Burbank CA 91505-4809
Providence Saint Joseph Medical Communication Disorders Center Providence Saint Joseph 7.35.97 Center Type C 02/22/2005 Full Los Angeles 1336173269 Providence Health System Med 501 S Buena Vista
Burbank CA 91505-4866
Providence Speech And Hearing Communication Disorders Center 7.35.58 Center Type C 10/22/2001 Full Orange 1215993704 Providence Speech And Providence Speech And 1301 W Providence Avenue (714) 639-4990
Orange CA 92868-3892
Providence Speech And Hearing Communication Disorders Center 7.35.143 Center Type C 11/09/2012 Full Orange 1215993704 Providence Speech And Providence Speech And 1301 W Providence Avenue (714) 639-4990
Orange CA 92868-3892
9/25/21 6:58 PM Page 47 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Providence Speech And Hearing Communication Disorders Center 7.35.145 Center Type C 05/02/2013 Full Orange 1215993704 Providence Speech And Providence Speech And 1301 W Providence Avenue (714) 639-4990
Orange CA 92868-3892
Providence Speech And Hearing Communication Disorders Center 7.35.154 Center Type C 06/25/2014 Full Orange 1215993704 Providence Speech And Providence Speech And 1301 W Providence Avenue (714) 639-4990
Orange CA 92868-3892
Providence Speech And Hearing Communication Disorders Center 7.35.157 Center Type C 08/31/2015 Full Orange 1215993704 Providence Speech And Providence Speech And 1301 W Providence Avenue (714) 639-4990
Orange CA 92868-3892
Community Neonatal Intensive 7.13.33 Providence Tarzana Medical Center Care Unit 04/06/2009 Full Los Angeles 1821250762 Providence Health System Providence Tarzana Med 18321 Clark Street (818) 881-0800
Tarzana CA 91356-3501
7.38.52 Providence Tarzana Medical Center HRIF - Community 04/06/2009 Provisional Los Angeles 1821250762 Providence Health System Providence Tarzana Med 18321 Clark Street (818) 881-0800
Tarzana CA 91356-3501
Community Neonatal Intensive 7.13.41 Queen of The Valley Hospital Care Unit 02/24/2006 Provisional Los Angeles 1063441293 Citrus Valley Med Ctr Citrus Valley Med Ctr 1115 S Sunset Avenue (626) 962-4011
West Covina CA 91790-3940
Rady Children's At Palomar Medical Community Neonatal Intensive 7.13.13 Center Downtown Escondido Care Unit 12/07/1983 Full San Diego 1457321317 Palomar Medical Center Palomar Medical Center 555 E Valley Parkway (619) 745-2300
Escondido CA 92025-3048
Community Neonatal Intensive 7.13.107 Rady Children's At Scripps La Jolla Care Unit 01/26/2018 Full San Diego 1841277704 Scripps Health Scripps Memorial Hospital 9888 Genesee Avenue (858) 457-4123
La Jolla CA 92037-1205
Intermediate Neonatal Intensive 7.14.51 Rady Children's At Scripps La Jolla Care Unit 01/17/1990 Provisional San Diego 1841277704 Scripps Health Scripps Memorial Hosp 9888 Genesee Avenue (858) 457-4123
La Jolla CA 92037-1205
Rady Children's At Scripps Intermediate Neonatal Intensive 7.14.78 Memorial Hospital Encinitas Care Unit 01/10/2017 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
9/25/21 6:58 PM Page 48 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Rady Children's At Scripps Mercy Intermediate Neonatal Intensive Scripps Mercy Hospital 7.14.55 Hospital Chula Vista Care Unit 04/12/2018 Full San Diego 1659359446 Scripps Health Chula 435 H Street (619) 691-7000
Chula Vista CA 91910-4307
Rady Children's At Scripps Mercy Intermediate Neonatal Intensive 7.14.24 Hospital San Diego Care Unit 09/30/1993 Full San Diego 1659359446 Scripps Health Scripps Mercy Hospital 4077 5th Avenue (858) 927-5164
San Diego CA 92103-2105
Communication Disorders Center 7.35.78 Rady Children's Health Services Type C 09/17/2001 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
Rady Children's Hospital At Rancho Community Neonatal Intensive 7.13.108 Springs Care Unit 08/16/2019 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.02.15 Rady Children's Hospital San Diego Cardiac Center 02/23/1982 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.03.05 Rady Children's Hospital San Diego Craniofacial Center 01/04/1980 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.05.22 Rady Children's Hospital San Diego Rehabilitation Center 01/05/1984 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.07.05 Rady Children's Hospital San Diego Amputee Center 01/01/1978 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Myelomeningocele (Spina Bifida) 7.08.10 Rady Children's Hospital San Diego Center 12/01/1981 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Endocrine/Metabolic (PKU) 7.09A.1 Rady Children's Hospital San Diego Center 01/01/2000 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
9/25/21 6:58 PM Page 49 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.09.06A Rady Children's Hospital San Diego Metabolic Center 04/14/1970 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.09.06B Rady Children's Hospital San Diego Endocrine Center 04/14/1970 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.10.13 Rady Children's Hospital San Diego Renal Center 08/26/2003 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Cystic Fibrosis and Other 7.11.16 Rady Children's Hospital San Diego Pulmonary Disease Center 05/16/1993 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Regional Neonatal Intensive 7.12.10 Rady Childrens Hospital San Diego Care Unit 11/22/1988 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.15.12 Rady Children's Hospital San Diego Hemophilia Center 11/05/1981 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.16.11 Rady Children's Hospital San Diego Hematology/Oncology Center 12/22/1980 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.17.24 Rady Children's Hospital San Diego Sickle Cell Center 07/10/2002 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.19.04 Rady Children's Hospital San Diego Bone Marrow Transplant Center 01/01/1987 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Gastroenterology and Nutrition 7.23.06 Rady Children's Hospital San Diego Center 12/10/1981 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Specified Inherited Neurologic 7.24.07 Rady Children's Hospital San Diego Disease Center 11/05/1982 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.25.20 Rady Children's Hospital San Diego Pediatric Intensive Care Unit 05/23/1990 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Infectious Diseases and 7.26.07 Rady Children's Hospital San Diego Immunologic Disorders 08/22/1988 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.27.09 Rady Children's Hospital San Diego Heart Transplant Center 10/23/2018 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
Neonatal Extra-Corporeal 7.29.05 Rady Children's Hospital San Diego Membrane Oxygenation (ECMO) 11/22/1988 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
7.36.4 Rady Children's Hospital San Diego Cochlear Implants 12/29/1999 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
7.37.05 Rady Children's Hospital San Diego HRIF - Regional 11/22/1988 Full San Diego 1710065933 Rady Children's Hosp Rady Children's Hosp 3020 Childrens Way (619) 576-1700
San Diego CA 92123-4223
Rady Children's Hospital San Diego 7.20.53 Epilepsy miscellaneous 08/16/2019 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
Rady Children's Hospital San Diego 7.20.05 Rheumatology miscellaneous 05/08/1978 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
Rady Children's Specialists of San Communication Disorders Center 7.35.111 Diego At Escondido Type C 01/25/2007 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
9/25/21 6:58 PM Page 51 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Rady Children's Specialists of San Communication Disorders Center 7.35.162 Diego At Murrieta Medical Plaza Type C 02/11/2019 Full Riverside 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700
San Diego CA 92123-4223
Rady Children's Specialists of San Communication Disorders Center 7.35.86 Diego At Oceanside North Coastal Type C 09/17/2001 Full San Diego 1710065933 Radys Childrens Hospital Rady Children's Hosp 3020 Childrens Way (858) 576-1700 Center
San Diego CA 92123-4223
Rancho Los Amigos National County of Los Angeles 7.05.10 Rehabilitation Center Rehabilitation Center 03/03/1980 Full Los Angeles 1275540171 Rancho National Rehabilitation 7601 Imperial Highway (562) 401-7022
Downey CA 90242-3456
Rancho Los Amigos National Communication Disorders Center 7.34.22 Rehabilitation Center Type B 08/27/2001 Full Los Angeles 1942487160 Rancho Los Amigos Rancho Los Amigos 7601 E Imperial Highway (562) 401-7022
Downey CA 90242-3456
Communication Disorders Center 7.35.74 Redding Hearing Institute Type C 04/26/2004 Provisional Shasta 1356434021 Redding Hearng Institute Redding Hearng Institute 499 Hemsted Drive (530) 226-3320
Suite A
Redding CA 96002-0165
Community Neonatal Intensive San 7.13.02 Redlands Community Hospital Care Unit 12/14/1989 Provisional Bernardino 1043354111 Redlands Community Hosp Redlands Community Hosp 350 Terracina Boulevard (714) 793-3101
Redlands CA 92373-4897
Communication Disorders Center 7.35.123 Redwood Audiology Type C 07/16/2008 Full Humboldt 1952581084 Terrill, Russell T Redwood Audiology 4677 Valley E Boulevard (707) 822-9122
Suite 2
Arcata CA 95521-4630
Intermediate Neonatal Intensive 7.14.74 Regional Medical Center San Jose Care Unit 03/08/2013 Full Santa Clara 1821041765 San Jose Healthcare Sys Regional Med Ct San Jose 225 N Jackson Avenue (702) 855-1022
San Jose CA 95116-1603
9/25/21 6:58 PM Page 52 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Rehabilitation Institute At Santa Santa 7.05.14 Barbara Rehabilitation Center 01/28/1988 Provisional Barbara 1003852591 Rehabilitation Institute Rehabilitation Institute 2415 De La Vina Street (805) 967-5934
Santa Barbara CA 93105-3819
Community Neonatal Intensive Riverside Community 7.13.68 Riverside Community Hospital Care Unit 06/23/2004 Full Riverside 1114971660 Riverside Healthcare System Hospital 4445 Magnolia Avenue (951) 788-3000
Riverside CA 92501-4135
Riverside University Health System Community Neonatal Intensive 7.13.50 Medical Center Care Unit 04/08/1983 Full Riverside 1821159195 County of Riverside Riverside University Health 26520 Cactus Avenue (951) 486-4470
Moreno Valley CA 92555-3927
Riverside University Health System 7.25.01 Medical Center Pediatric Intensive Care Unit 12/10/2009 Provisional Riverside 1821159195 County of Riverside Riverside University Health 26520 Cactus Avenue (951) 486-4470
Moreno Valley CA 92555-3927
Riverside University Health System Communication Disorders Center 7.35.149 Medical Center Type C 01/29/2014 Full Riverside 1821159195 Riverside Co Regional Riverside Co Regional 26520 Cactus Avenue
Moreno Valley CA 92555-3927
Riverside University Health System 7.38.49 Medical Center HRIF - Community 04/08/2000 Conditional Riverside 1821159195 County of Riverside Riverside University Health 26520 Cactus Avenue (951) 486-4470
Moreno Valley CA 92555-3927
Riverview Hearing, Speech, And Communication Disorders Center 7.35.75 Language Centers Type C 03/05/2004 Full Los Angeles 1598854846 Basil, Sherwin A M A Basil, Sherwin A M A 5842 E 2nd Street (562) 439-9539
Long Beach CA 90803-5039
Riverview Hearing, Speech, And Communication Disorders Center 7.35.116 Language Centers Type C 07/30/2007 Full Orange 1598854846 Basil, Sherwin A M A Basil, Sherwin A M A 5842 E 2nd Street (562) 439-9539
Long Beach CA 90803-5039
7.17.04 Saint Agnes Medical Center Sickle Cell Center 07/03/1997 Conditional Fresno 1205845567 Saint Agnes Medical Center Saint Agnes Medical Center 1303 E Herndon Avenue (559) 450-3000
Fresno CA 93720-3309
Salinas Valley Memorial Healthcare Community Neonatal Intensive 7.13.89 System Care Unit 06/01/2006 Full Monterey 1750384079 Salinas Valley Mem Hosp Salinas Valley Mem Hosp 450 E Romie Lane (408) 757-4333
Salinas CA 93901-4098
9/25/21 6:58 PM Page 53 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive San 7.13.37 San Antonio Regional Hospital Care Unit 03/09/1994 Provisional Bernardino 1780681189 San Antonio Regional San Antonio Community Ho 999 San Bernardino Road (714) 985-2811
Upland CA 91786-4922
San 7.38.30 San Antonio Regional Hospital HRIF - Community 03/09/2000 Provisional Bernardino 1780681189 San Antonio Regional San Antonio Community Ho 999 San Bernardino Road (714) 985-2811
Upland CA 91786-4922
Communication Disorders Center San San Francisco San Francisco 7.35.126 San Francisco Otolaryngology Type C 03/18/2010 Full Francisco 1770757551 Otolaryngology Otolaryngology 450 Sutter Street (415) 362-5443
Suite 933
San Francisco CA 94108-3997
Community Neonatal Intensive 7.13.66 San Gabriel Valley Medical Center Care Unit 12/29/2003 Full Los Angeles 1275720377 Ahmc San Gabriel Valley San Gabriel Valley Medical 438 W Las Tunas Drive (626) 289-5454
San Gabriel CA 91776-1216
7.04.34 San Joaquin General Hospital Cleft Palate Center 05/27/1987 Provisional San Joaquin San Joaquin Gen Hosp San Joaquin Gen Hosp 500 W Hospital Road (209) 982-1800
French Camp CA 95231
7.05.34 San Joaquin General Hospital Rehabilitation Center 08/31/1987 Conditional San Joaquin San Joaquin Gen Hosp San Joaquin Gen Hosp 500 W Hospital Road (209) 982-1800
French Camp CA 95231
Community Neonatal Intensive 7.13.10 San Joaquin General Hospital Care Unit 06/06/1989 Conditional San Joaquin 1275605180 San Joaquin General Hosp San Joaquin General 500 W Hospital Road (209) 468-6937
French Camp CA 95231
Communication Disorders Center 7.35.61 San Joaquin General Hospital Type C 08/20/2001 Full San Joaquin 1952476525 San Joaquin General Hosp San Joaquin General Hosp 500 W Hospital Road (209) 468-6937
French Camp CA 95231
7.38.07 San Joaquin General Hospital HRIF - Community 12/12/2017 Full San Joaquin San Joaquin Gen Hosp San Joaquin Gen Hosp 500 W Hospital Road (209) 982-1800
French Camp CA 95231
9/25/21 6:58 PM Page 54 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Santa 7.09.37B Santa Barbara Cottage Hospital Endocrine Center 05/08/2013 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
Community Neonatal Intensive Santa 7.13.11 Santa Barbara Cottage Hospital Care Unit 01/08/2004 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
Santa 7.16.32 Santa Barbara Cottage Hospital Hematology/Oncology Center 05/08/2013 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
miscellaneous - Rheumatology Santa 7.20.47 Santa Barbara Cottage Hospital Center 02/13/2018 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
Gastroenterology and Nutrition Santa 7.23.22 Santa Barbara Cottage Hospital Center 05/08/2013 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
Santa 7.25.23 Santa Barbara Cottage Hospital Pediatric Intensive Care Unit 09/09/2004 Provisional Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
Santa 7.38.08 Santa Barbara Cottage Hospital HRIF - Community 01/08/2004 Full Barbara 1477554152 Santa Barbara Cottage Santa Barbara Cottage Ho 400 W Pueblo (805) 682-7111
Santa Barbara CA 93105-4353
7.02.27 Santa Clara Valley Medical Center Cardiac Center 06/21/1984 Conditional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
7.05.12 Santa Clara Valley Medical Center Rehabilitation Center 06/20/1978 Provisional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
Myelomeningocele (Spina Bifida) 7.08.21 Santa Clara Valley Medical Center Center 01/01/2000 Full Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
9/25/21 6:58 PM Page 55 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Endocrine/Metabolic (PKU) 7.09B.2 Santa Clara Valley Medical Center Center 08/20/2004 Provisional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
7.10.09 Santa Clara Valley Medical Center Renal Center 02/01/2010 Full Santa Clara 1063406551 Santa Clara Med Ctr Santa Clara Med Ctr 751 S Bascom Avenue (408) 885-7200
San Jose CA 95128-2604
Cystic Fibrosis and Other 7.11.26 Santa Clara Valley Medical Center Pulmonary Disease Center 01/01/2000 Provisional Santa Clara 1063406551 Santa Clara Med Ctr Santa Clara Med Ctr 751 S Bascom Avenue (408) 885-7200
San Jose CA 95128-2604
Regional Neonatal Intensive 7.12.15 Santa Clara Valley Medical Center Care Unit 08/20/2004 Provisional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
Gastroenterology and Nutrition 7.23.19 Santa Clara Valley Medical Center Center 02/15/2006 Full Santa Clara Santa Clara Vly Med Ctr Santa Clara Vly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
7.25.12 Santa Clara Valley Medical Center Pediatric Intensive Care Unit 05/16/1984 Conditional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
Infectious Diseases and 7.26.11 Santa Clara Valley Medical Center Immunologic Disorders 11/28/1988 Conditional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
Communication Disorders Center 7.35.62 Santa Clara Valley Medical Center Type C 08/27/2001 Full Santa Clara 1124107420 County of Santa Clara Santa Clara Vlly MD Ct 2220 Moorpark Avenue (408) 885-7200
San Jose CA 95128-2613
7.37.15 Santa Clara Valley Medical Center HRIF - Regional 08/20/2004 Provisional Santa Clara Santa Clara Vlly Med Ctr Santa Clara Vlly Med Ctr 751 S Bascom Avenue (408) 299-5100
San Jose CA 95128-2604
Santa Clara Valley Medical Center 7.20.33 Neurogenetics miscellaneous 01/31/2014 Full Santa Clara 1063406551 Santa Clara Med Ctr Santa Clara Med Ctr 751 S Bascom Avenue (408) 885-7200
San Jose CA 95128-2604
9/25/21 6:58 PM Page 56 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.33.126 Santa Rosa Head Neck Surgery Type A 07/17/2013 Full Sonoma 1396040226 Northern California Medical Northern California Medical 1701 4th Street (707) 523-3024
Suite 120
Santa Rosa CA 95404-3661
Community Neonatal Intensive 7.13.99 Santa Rosa Memorial Hospital Care Unit 03/23/2015 Full Sonoma 1134152549 Santa Rosa Memorial Hosp Santa Rosa Memorial Hosp 1165 Montgomery Drive (707) 546-3210
Santa Rosa CA 95405-4801
Communication Disorders Center Second Chance Hearing Second Chance Hearing 7.33.123 Second Chance Hearing Inc Type A 02/22/2012 Full Ventura 1760771349 Center Center 3180 Willow Lane (805) 870-4498
Suite 218
Thousand Oaks CA 91361-4992
Intermediate Neonatal Intensive 7.14.61 Sharp Chula Vista Medical Center Care Unit 05/10/1995 Full San Diego 1396728630 Sharp Chula Vista Med Ct Sharp Chula Vista Med Ct 751 Medical Center (714) 421-6110
Ct
Chula Vista CA 91911-6617
7.05.29 Sharp Grossmont Hospital Rehabilitation Center 05/31/1991 Provisional San Diego 1528041811 Grossmont Hospital CorporatiGrossmont Hosp Corp 5555 Grossmont Center Drive (619) 465-0711
La Mesa CA 91942-3019
Community Neonatal Intensive 7.13.20 Sharp Grossmont Hospital Care Unit 05/10/2008 Full San Diego 1528041811 Grossmont Hosp Grossmont Hosp Corp 5555 Grossmont Center Drive (619) 465-0711
La Mesa CA 91942-3077
Communication Disorders Center 7.35.141 Sharp Grossmont Hospital Type C 11/27/2012 Provisional San Diego 1528041811 Grossmont Hospital CorporatiGrossmont Hosp Corp 5555 Grossmont Center Drive (619) 465-0711
La Mesa CA 91942-3019
Sharp Mary Birch Hospital For Community Neonatal Intensive 7.13.35 Women And Newborns Care Unit 04/10/2018 Full San Diego 1972586402 Sharp Memorial Hosp Sharp Mary Birch Hosp 3003 Health Center Drive (619) 541-4161
San Diego CA 92123-2700
Sharp Mary Birch Hospital For 7.38.28 Women And Newborns HRIF - Community 04/10/2018 Full San Diego 1972586402 Sharp Memorial Hosp Sharp Mary Birch Hosp 3003 Health Center Drive (619) 541-4161
San Diego CA 92123-2700
9/25/21 6:58 PM Page 57 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.05.19 Sharp Memorial Hospital Rehabilitation Center 01/04/1984 Provisional San Diego 1407839921 Sharp Memorial Hosp Sharp Memorial Hosp 7901 Frost Street (714) 277-6121
San Diego CA 92123-2701
Sherman Oaks Ear And Hearing Communication Disorders Center 7.35.134 Institute Type C 09/21/2011 Full Los Angeles 1437106457 Godinez, Andres Godinez, Andres 885 S Atlantic Boulevard (818) 783-1035
Monterey Park CA 91754-4733
Communication Disorders Center 7.35.131 Sherman Oaks Ear Institute Type C 07/21/2011 Provisional Los Angeles 1437106457 Godinez, Andres Godinez, Andres 885 S Atlantic Boulevard (818) 783-1035
Monterey Park CA 91754-4733
Shriners Hospital For Children- 7.05.44 Northern California Rehabilitation Center 12/31/2012 Full Sacramento 1962530451 Shriners Hospitals For Shriners Hospitals For Child 2425 Stockton Boulevard (916) 453-2002
Sacramento CA 95817-2215
Shriners Hospital For Children- Myelomeningocele (Spina Bifida) 7.08.22 Northern California Center 10/28/2013 Full Sacramento 1962530451 Shriners Hospitals For Shriners Hospitals For Child 2425 Stockton Boulevard (916) 453-2002
Sacramento CA 95817-2215
Shriners Hospital Pediatric 7.20.55 Colorectal Urology SCC miscellaneous 07/22/2020 Full Sacramento 1962530451 Shriners Hospitals For Shriners Hospitals For Child 2425 Stockton Boulevard (916) 453-2002
Sacramento CA 95817-2215
Sierra Vista Regional Medical Community Neonatal Intensive San Luis 7.13.47 Center Care Unit 11/25/1997 Full Obispo 1639101116 Sierra Vista Regional Sierra Vista Regional 1010 Murray Street (805) 543-6550
Sn Luis Obisp CA 93405-8800
Sierra Vista Regional Medical San Luis 7.38.57 Center HRIF - Community 12/25/1997 Provisional Obispo 1639101116 Sierra Vista Regional Sierra Vista Regional 1010 Murray Street (805) 543-6550
Sn Luis Obisp CA 93405-8800
Communication Disorders Center 7.33.121 Sonus Anaheim Type A 08/23/2011 Provisional Orange 1164730305 Wsm Hearing Centers of Sonus Sf0007 1801 W Romneya Drive (714) 956-2881
Suite 605
Anaheim CA 92801-1830
9/25/21 6:58 PM Page 58 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.33.118 SONUS ARCADIA Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 612 W Duarte Road (626) 445-2844
Suite 601
Arcadia CA 91007-9240
Communication Disorders Center 7.33.108 Sonus Atlantic Type A 04/28/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 2530 Atlantic Avenue (562) 426-2137
Suite D
Long Beach CA 90806-2741
Communication Disorders Center 7.33.112 SONUS CERRITOS Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 10929 S Street (562) 860-1504
Suite 202 B
Cerritos CA 90703-5368
Communication Disorders Center 7.33.114 SONUS CORONA Type A 05/13/2011 Provisional Riverside 1760783344 Serendipity Hearing Inc Sonus Sf0010 802 Magnolia Avenue (818) 789-0463
Suite 208
Corona CA 92879-3157
Communication Disorders Center 7.33.116 Sonus Encino Type A 05/05/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 16030 Ventura Boulevard (818) 789-0463
Suite 605
Encino CA 91436-4471
Communication Disorders Center 7.33.119 SONUS GLENDORA Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 1135 E Route 66 (626) 914-5661
Suite 111
Glendora CA 91740-3778
Communication Disorders Center 7.33.115 SONUS IRVINE Type A 05/13/2011 Provisional Orange 1760783344 Serendipity Hearing Inc Sonus Sf0010 4505 Barranca Parkway (949) 262-7190
Suite A
Irvine CA 92604-4708
9/25/21 6:58 PM Page 59 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.33.109 SONUS LANCASTER Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 44407 10th Street (661) 942-7030
W
Lancaster CA 93534-3345
Communication Disorders Center 7.33.106 SONUS MISSION HILLS Type A 05/02/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 11550 Indian Hills Road (818) 837-4327
Suite 210
Mission Hills CA 91345-1202
Communication Disorders Center San 7.33.104 Sonus Montclair Type A 05/13/2011 Provisional Bernardino 1760783344 Serendipity Hearing Inc Sonus Sf0010 9625 Monte Vista Avenue (909) 624-0991
Suite 102
Montclair CA 91763-2234
Communication Disorders Center 7.33.122 Sonus Newhall Type A 10/18/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 25078 Peachland Avenue (661) 253-4514
Suite F
Newhall CA 91321-2554
Communication Disorders Center 7.33.107 SONUS NORTHRIDGE Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 Unknown (818) 734-9124
Unknown CA 00000
Communication Disorders Center 7.33.117 SONUS ORANGE Type A 05/13/2011 Provisional Orange 1760783344 Serendipity Hearing Inc Sonus Sf0010 904 W Town And Country R (714) 558-2666
Orange CA 92868-4721
Communication Disorders Center 7.33.105 SONUS SAN GABRIEL Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 13922 Seal Beach Boulevard (562) 431-1512
Suite B
Seal Beach CA 90740-5377
Communication Disorders Center 7.33.113 SONUS SANTA ANA Type A 04/27/2011 Provisional Orange 1760783344 Serendipity Hearing Inc Sonus Sf0010 800 N Tustin Avenue (714) 543-9263
Suite 1
Santa Ana CA 92705-3605
9/25/21 6:58 PM Page 60 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.33.38 Sonus Santa Monica Type A 06/14/2004 Provisional Los Angeles 1548369226 Sonus-Usa, Inc Sonus-Usa, Inc 1911 Wilshire Boulevard (310) 828-1055
Santa Monica CA 90403-5605
Communication Disorders Center 7.33.110 SONUS WHITIER Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 8409 Pioneer Boulevard (562) 593-0703
Whittier CA 90606-2947
Communication Disorders Center 7.33.111 Sonus Wilshire Type A 05/13/2011 Provisional Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 13922 Seal Beach Boulevard (562) 431-1512
Suite B
Seal Beach CA 90740-5377
Communication Disorders Center 7.33.125 Sonus Woodruff Type A 02/22/2012 Full Los Angeles 1760783344 Serendipity Hearing Inc Sonus Sf0010 3816 Woodruff Avenue (562) 982-0050
Suite 305
Long Beach CA 90808-2146
Communication Disorders Center 7.34.5 Sound Advice Type B 05/19/2003 Provisional Los Angeles 1306980057 Hearing Care Associates Hearing Care Associates 4001 W Alameda Avenue (818) 841-0066
Suite 101
Burbank CA 91505-4338
Sound Solutions Hearing And Communication Disorders Center 7.33.6 Balance Centers Type A 08/04/2003 Full Orange 1083714893 Caldwell-Miller, Mikal M Sound Solutions Hearing 7851 Walker Street (714) 523-4327
Suite 206
La Palma CA 90623-1746
Sound Solutions Hearing Balance Communication Disorders Center 7.33.99 Centers Type A 07/30/2008 Full Orange 1083714893 Caldwell-Miller, Mikal M Sound Solutions Hearing 7851 Walker Street (714) 523-4327
Suite 206
La Palma CA 90623-1746
Stanford Hospital-Adult Heart 7.27.7 Transplant Center Heart Transplant Center 03/22/1994 Provisional Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
9/25/21 6:58 PM Page 61 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Stanford Hospital-Adult Liver 7.28.7 Transplant Center Liver Transplant Center 02/15/1995 Provisional Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
Stanford Hospital-Adult Lung Heart and Lung Transplant 7.31.5 Transplant Center 01/01/1987 Provisional Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
7.10.22 Stanford Hospital And Clinics Renal Center 01/01/2011 Full Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
7.19.11 Stanford Hospital And Clinics Bone Marrow Transplant Center 01/01/1987 Provisional Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
7.36.07 Stanford Hospital And Clinics Cochlear Implants 01/01/2006 Provisional Santa Clara 1871543215 Stanford Hospital Clinics Stanford Hospital Clinics 300 Pasteur Drive (650) 723-4000
Stanford CA 94305-2200
Community Neonatal Intensive San St Bernardine Medical 7.13.23 St Bernardine Medical Center Care Unit 08/05/1993 Provisional Bernardino 1689769911 Dignity Health Center 2101 N Waterman Avenue (415) 438-5500
San Bernardino CA 92404-4836
Community Neonatal Intensive 7.13.29 St Francis Medical Center Care Unit 04/01/1998 Full Los Angeles 1114547114 Prime Healthcare Services St Francis Medical Center 3630 E Imperial Highway (310) 900-8900
Lynwood CA 90262-2609
7.05.32 St John's Regional Medical Center Rehabilitation Center 11/20/1992 Provisional Ventura 1073665360 Catholic Healthcare West St Johns Reg Med Cntr 1600 N Rose Avenue (805) 988-2500
Oxnard CA 93030-3722
Community Neonatal Intensive 7.13.79 St John's Regional Medical Center Care Unit 03/07/1995 Full Ventura 1073665360 Catholic Healthcare West St Johns Reg Med Cntr 1600 N Rose Avenue (805) 988-2500
Oxnard CA 93030-3722
St Johns Regional Medical 7.38.66 St John's Regional Medical Center HRIF - Community 08/31/2006 Provisional Ventura 1073665360 Dignity Health Ce 1600 N Rose Avenue (415) 438-5500
Oxnard CA 93030-3722
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Community Neonatal Intensive 7.13.55 St Joseph's Medical Center Care Unit 04/08/1997 Full San Joaquin 1528190931 St Joseph's Medical Ctr Catholic Healthcare W II 1800 N California Street (209) 467-6384
Stockton CA 95204-6019
St Jude Centers For Rehabilitation 7.05.27 Wellness Rehabilitation Center 01/19/1988 Provisional Orange 1891904942 St Jude Medical Ctr St Jude Medical Ctr 101 E Valencia Mesa Drive (714) 871-3280
Fullerton CA 92835-3809
St Jude Medical Center Community Community Neonatal Intensive 7.13.110 Nicu Care Unit 08/08/2019 Full Orange 1891904942 St Jude Hospital St Jude Medical Ctr 101 E Valencia Mesa Drive (714) 871-3280
Fullerton CA 92835-3809
Community Neonatal Intensive 7.13.31 St Mary Medical Center Care Unit 06/11/2004 Full Los Angeles St Mary Medical Center St Mary Medical Center 1050 Linden Avenue (310) 491-9129
Long Beach CA 90813-3321
St Mary Medical Center Apple Community Neonatal Intensive San 7.13.102 Valley Care Unit 11/01/2015 Full Bernardino 1669456299 St Mary Medical Center Providence St Mary Medical 18300 Us Highway (760) 242-2311
PO Box 1225 18
Apple Valley CA 92307-2206
Stockton Hearing And Speech Communication Disorders Center Stockton Hearing And 7.33.32 Center Type A 08/27/2001 Full San Joaquin 1396004172 Valley Audiology Speech 4623 Quail Lakes Drive (209) 951-6491
Stockton CA 95207-5258
Sutter Capitol Pavilion Ent Communication Disorders Center 7.33.72 Audiology Type A 08/10/2004 Full Sacramento 1952327256 Sutter Valley Medical Founda Sutter Medical Foundation 1201 Alhambra Boulevard (916) 731-7720
Suite 420
Sacramento CA 95816-5242
Communication Disorders Center 7.33.8 Sutter Gould Medical Foundation Type A 10/01/2001 Full Stanislaus 1801833496 Sutter Gould Medical Gould Medical Group Inc 600 Coffee Road (916) 854-6778
Modesto CA 95355-4201
7.02.21 Sutter Medical Center, Sacramento Cardiac Center 07/15/1976 Conditional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
9/25/21 6:58 PM Page 63 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
7.03.13 Sutter Medical Center, Sacramento Craniofacial Center 12/19/1978 Provisional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
7.09.22A Sutter Medical Center, Sacramento Metabolic Center 09/11/1991 Conditional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
Sutter Medical Center 7.09.22B Sutter Medical Center, Sacramento Endocrine Center 09/11/1991 Conditional Sacramento 1811946734 Sutter Health Hospitals Sacram 2825 Capitol Avenue (916) 887-0000
Sacramento CA 95816-5616
Cystic Fibrosis and Other 7.11.19 Sutter Medical Center, Sacramento Pulmonary Disease Center 06/24/1993 Provisional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
Regional Neonatal Intensive Sutter Medical Center 7.12.26 Sutter Medical Center, Sacramento Care Unit 08/01/2004 Full Sacramento 1811946734 Sutter Health Hospitals Sacram 2825 Capitol Avenue (916) 887-0000
Sacramento CA 95816-5616
Sutter Medical Center 7.16.22 Sutter Medical Center, Sacramento Hematology/Oncology Center 02/01/1995 Provisional Sacramento 1811946734 Sutter Health Hospitals Sacram 2825 Capitol Avenue (916) 887-0000
Sacramento CA 95816-5616
7.17.26 Sutter Medical Center, Sacramento Sickle Cell Center 09/01/2004 Provisional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
Gastroenterology and Nutrition 7.23.15 Sutter Medical Center, Sacramento Center 05/21/1993 Full Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
7.25.16 Sutter Medical Center, Sacramento Pediatric Intensive Care Unit 08/13/2004 Provisional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
Neonatal Extra-Corporeal 7.29.08 Sutter Medical Center, Sacramento Membrane Oxygenation (ECMO) 03/30/1989 Full Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
9/25/21 6:58 PM Page 64 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center Sutter Medical Center 7.35.79 Sutter Medical Center, Sacramento Type C 08/13/2004 Full Sacramento 1811946734 Sutter Health Hospitals Sacram 2825 Capitol Avenue (916) 887-0000
Sacramento CA 95816-5616
7.37.16 Sutter Medical Center, Sacramento HRIF - Regional 08/01/2004 Provisional Sacramento 1811946734 Sutter Chs Central Sutter Hlth Sacto Sierra 2801 L Street (916) 455-2661
Sacramento CA 95816-5615
Sutter Medical Foundation Communication Disorders Center 7.33.124 Audiology Services Type A 02/22/2012 Full Solano 1184859894 Sutter Valley Medical Sutter Medical Foundation 2702 Low Ct (707) 432-2600
Fairfield CA 94534-9771
Communication Disorders Center Sutter North Medical 7.35.129 Sutter North Medical Group Type C 11/16/2010 Full Sutter 1992939565 Sutter Valley Medical Founda 460 Plumas Boulevard (530) 749-3399
Yuba City CA 95991-5005
Community Neonatal Intensive Sutter Roseville Medical 7.13.103 Sutter Roseville Medical Center Care Unit 02/01/2016 Full Placer 1356390264 Sutter Valley Hospitals Cen 1 Medical Plaza Drive (916) 781-1000
Roseville CA 95661-3037
Sutter Santa Rosa Regional Community Neonatal Intensive 7.13.24 Hospital Care Unit 04/16/1992 Full Sonoma 1740413798 Sutter Bay Hospitals Sutter Santa Rosa Regional 30 Mark W Springs Road (707) 576-4000
Santa Rosa CA 95403-1436
Sutter Santa Rosa Regional 7.38.74 Hospital HRIF - Community 10/17/2011 Full Sonoma 1740413798 Sutter Bay Hospitals Sutter Santa Rosa Regional 30 Mark W Springs Road (707) 576-4000
Santa Rosa CA 95403-1436
Communication Disorders Center 7.33.120 Tahoe Forest Multispeciality Clinics Type A 09/08/2011 Provisional Nevada 1750412300 Tahoe Forest Hosp Dist Tahoe Forest Multispecialty 10956 Donner Pass Road (530) 550-6700
Suite 340
Truckee CA 96161-4885
Communication Disorders Center 7.33.10 The Hearing Doctor Type A 08/12/2001 Full Los Angeles 1073671954 Marghzar, Sol MS Ccc-A Inc The Hearing Doctor 3831 Hughes Avenue (310) 559-4884
Suite 600 B
Culver City CA 90232-6843
9/25/21 6:58 PM Page 65 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Torrance Memorial Medical Burn 7.20.52 Center miscellaneous 06/20/2019 Full Los Angeles 1467459776 Torrance Memorial Med Ct Torrance Memorial Med Ct 3330 Lomita Boulevard (310) 325-9110
Torrance CA 90509-9977
San 7.05.45 Totally Kids Rehabilitation Hospital Rehabilitation Center 01/01/2015 Full Bernardino 1003133695 Mountain View Child Care IncTotally Kids Rehabilitation 1720 Mountain View Avenue (909) 796-6915
Loma Linda CA 92354-1727
Community Neonatal Intensive 7.13.12 Tri-City Medical Center Care Unit 01/08/1992 Full San Diego 1801861190 Tri City Hospital Tri-City Medical Center 4002 Vista Way (760) 940-3348
Oceanside CA 92056-4506
7.02.07 UC Davis Medical Center Cardiac Center 07/31/2017 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.03.11 UC Davis Medical Center Craniofacial Center 04/16/2020 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.05.07 UC Davis Medical Center Rehabilitation Center 08/28/2019 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.07.06 UC Davis Medical Center Amputee Center 02/15/1983 Conditional Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Myelomeningocele (Spina Bifida) 7.08.09 UC Davis Medical Center Center 08/17/2017 Conditional Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Endocrine/Metabolic (PKU) 7.09.11 UC Davis Medical Center Center 08/08/2017 Provisional Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.10.11 UC Davis Medical Center Renal Center 07/16/2019 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Cystic Fibrosis and Other 7.11.05 UC Davis Medical Center Pulmonary Disease Center 08/08/2017 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Regional Neonatal Intensive 7.12.09 U C Davis Medical Center Care Unit 01/06/1982 Full Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 453-2011
Sacramento CA 95817-2201
7.15.10 UC Davis Medical Center Hemophilia Center 07/28/2017 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.16.06 UC Davis Medical Center Hematology/Oncology Center 07/28/2017 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.17.02 UC Davis Medical Center Sickle Cell Center 03/11/2020 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Gastroenterology and Nutrition 7.23.03 UC Davis Medical Center Center 07/16/2019 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Specified Inherited Neurologic 7.24.10 UC Davis Medical Center Disease Center 08/18/2017 Provisional Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.25.03 UC Davis Medical Center Pediatric Intensive Care Unit 11/08/2013 Full Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 453-2011
Sacramento CA 95817-2201
Infectious Diseases and 7.26.17 UC Davis Medical Center Immunologic Disorders 08/07/2017 Full Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
Communication Disorders Center 7.35.76 UC Davis Medical Center Type C 03/19/2004 Full Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.35.152 UC Davis Medical Center Type C 05/20/2014 Full Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.36.1 UC Davis Medical Center Cochlear Implants 06/20/2019 Full Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 453-2011
Sacramento CA 95817-2201
7.37.17 UC Davis Medical Center HRIF - Regional 01/06/1982 Provisional Sacramento 1710918545 U C Davis Medical Center U C Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
UC Davis Medical Center 7.20.06 Neuromuscular miscellaneous 08/07/2017 Conditional Sacramento 1700804200 UC Davis Medical Center UC Davis Medical Center 2315 Stockton Boulevard (916) 734-2011
Sacramento CA 95817-2201
7.20.24 UC Irvine Medical Burn Center miscellaneous 12/22/2010 Full Orange 1689608150 University of California University of California Irv 101 The City Drive (714) 456-7890
S
Orange CA 92868-3201
7.05.20 UC Irvine Medical Center Rehabilitation Center 12/19/2002 Provisional Orange Univ of Calif Irvine Univ of Calif Irvine 101 City Drive (714) 456-6011
S
Orange CA 92868-3201
Regional Neonatal Intensive 7.12.13 UC Irvine Medical Center Care Unit 10/22/2002 Full Orange 1689608150 University of California University of California Irv 101 The City Drive (714) 456-7890
S
Orange CA 92868-3201
Communication Disorders Center 7.35.35 UC Irvine Medical Center Type C 04/02/2004 Full Orange 1689608150 University of California University of California Irv 101 The City Drive (714) 456-7890
S
Orange CA 92868-3201
9/25/21 6:58 PM Page 68 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.35.77 UC Irvine Medical Center Type C 04/02/2004 Full Orange 1669437075 University Head Neck Surge Regents of The University of 101 City Drive (714) 456-7890
Building 25 S
Orange CA 92868-3201
7.36.08 UC Irvine Medical Center Cochlear Implants 02/11/2008 Provisional Orange 1689608150 University of California University of California Irv 101 The City Drive (714) 456-7890
S
Orange CA 92868-3201
7.37.20 UC Irvine Medical Center HRIF - Regional 01/01/2004 Provisional Orange Univ of Calif Irvine Univ of Calif Irvine 101 City Drive (714) 456-6011
S
Orange CA 92868-3201
UCLA Mattel Children's Hospital At 7.02.11 Ronald Reagan Cardiac Center 06/29/1987 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.03.10 Ronald Reagan Craniofacial Center 07/01/1969 Full Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.09.12A Ronald Reagan Metabolic Center 11/20/1980 Provisional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.09.12B Ronald Reagan Endocrine Center 11/01/1980 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.10.07 Ronald Reagan Renal Center 06/15/1981 Full Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At Cystic Fibrosis and Other 7.11.28 Ronald Reagan Pulmonary Disease Center 05/03/2011 Full Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
9/25/21 6:58 PM Page 69 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCLA Mattel Children's Hospital At Regional Neonatal Intensive 7.12.18 Ronald Reagan Care Unit 11/12/1981 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.16.09 Ronald Reagan Hematology/Oncology Center 09/25/1978 Conditional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.17.09 Ronald Reagan Sickle Cell Center 05/15/1981 Conditional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.19.07 Ronald Reagan Bone Marrow Transplant Center 01/01/1987 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.19.10 Ronald Reagan Bone Marrow Transplant Center 01/01/1987 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At miscellaneous - Neuromuscular 7.20.27 Ronald Reagan Center 04/19/2012 Full Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At Gastroenterology and Nutrition 7.23.02 Ronald Reagan Center 02/01/2001 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At Specified Inherited Neurologic 7.24.05 Ronald Reagan Disease Center 01/09/1984 Provisional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.25.04 Ronald Reagan Pediatric Intensive Care Unit 06/12/1984 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At Infectious Diseases and 7.26.02 Ronald Reagan Immunologic Disorders 06/06/1988 Conditional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
9/25/21 6:58 PM Page 70 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCLA Mattel Children's Hospital At 7.27.04 Ronald Reagan Heart Transplant Center 08/10/1993 Provisional Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.28.03 Ronald Reagan Liver Transplant Center 04/01/1989 Provisional Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At Selective Posterior Rhizotomy 7.30.03 Ronald Reagan Center 12/27/1989 Provisional Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At Communication Disorders Center 7.35.88 Ronald Reagan Type C 09/10/2001 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.36.2 Ronald Reagan Cochlear Implants 04/03/2003 Provisional Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.37.18 Ronald Reagan HRIF - Regional 11/12/1981 Conditional Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
UCLA Mattel Children's Hospital At 7.20.20 Ronald Reagan Epilepsy miscellaneous 01/01/2005 Conditional Los Angeles 1902803315 Regents of The University of Ronald Reagan UCLA Med 757 Westwood Plaza (310) 825-8021
Los Angeles CA 90095-8358
UCLA Mattel Children's Hospital At 7.20C.2 Ronald Reagan Rheumatology miscellaneous 01/01/2000 Full Los Angeles 1902803315 UCLA Hospital Clinics UCLA Hospital Clinics 10833 Le Conte Avenue (213) 825-5194
Los Angeles CA 90095-3075
Community Neonatal Intensive Santa Monica-UCLA 7.13.77 UCLA Medical Center-Santa MonicaCare Unit 04/26/2006 Full Los Angeles 1427055839 Regents University of Medical 1250 16th Street (310) 319-4000
Santa Monica CA 90404-1249
7.38.72 UCLA Medical Center-Santa MonicaHRIF - Community 10/16/2008 Full Los Angeles 1427055839 Santa Monica-UCLA Med Ct Regents of The Univ Ca 1250 16th Street (310) 319-4000
Santa Monica CA 90404-1249
9/25/21 6:58 PM Page 71 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UC San Diego Health Hillcrest- 7.15.23 Hillcrest Medical Center Hemophilia Center 01/01/2005 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
7.37.14 UC San Diego Health-Kearny Mesa HRIF - Regional 09/27/2017 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
UC San Diego Health La Jolla- Regional Neonatal Intensive 7.12.11 Jacobs Medical Center Care Unit 10/09/2017 Full San Diego Regents of The Univ Ca Regents of The Univ Ca 200 W Arbor Drive (619) 543-6222
San Diego CA 92103-9001
7.27.05 UC San Diego Medical Center Heart Transplant Center 09/16/1994 Provisional San Diego Regents of The Univ Ca Regents of The Univ Ca 200 W Arbor Drive (619) 543-6222
San Diego CA 92103-9001
7.28.09 UC San Diego Medical Center Liver Transplant Center 09/22/2009 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
Heart and Lung Transplant 7.31.03 UC San Diego Medical Center Center 09/16/1994 Provisional San Diego Regents of The Univ Ca Regents of The Univ Ca 200 W Arbor Drive (619) 543-6222
San Diego CA 92103-9001
UC San Diego Medical Center- Intermediate Neonatal Intensive 7.14.80 Hillcrest Care Unit 05/22/2019 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
UC San Diego Medical Center- Communication Disorders Center 7.35.65 Hillcrest Type C 10/27/2001 Full San Diego 1013079896 Regents of The Univ Ca University of Calif Univ 200 W Arbor Drive (619) 543-6222
San Diego CA 92103-9001
UC San Diego Medical Center- 7.20.28 Hillcrest Burn Center miscellaneous 04/23/2012 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
UCSD Mother-Child-Adolescent Hiv Infectious Diseases and 7.26.20 Program Immunologic Disorders 12/13/2010 Full San Diego 1184722779 Regents of The Univ Ca UCSD Medical Center 200 W Arbor Drive (619) 543-6060
San Diego CA 92103-1911
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCSF Benioff Children's Hospital Childrens Hospital And 7.02.03 Oakland Cardiac Center 10/16/1997 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.03.06 Oakland Craniofacial Center 03/07/1986 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.05.11 Oakland Rehabilitation Center 08/10/2017 Conditional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Myelomeningocele (Spina Bifida) Childrens Hospital And 7.08.20 Oakland Center 10/25/2002 Full Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Endocrine/Metabolic (PKU) Childrens Hospital And 7.09.02 Oakland Center 01/01/2000 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital 7.09.30A Oakland Metabolic Center 01/01/2001 Provisional Alameda 1003961251 Childrens Hosp Med Ctr Children's Hosp Med Cent 51ST And Grove Street (510) 428-3885x5724
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.09.31A Oakland Metabolic Center 01/01/2000 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.10.08 Oakland Renal Center 01/25/2010 Full Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Cystic Fibrosis and Other Childrens Hospital And 7.11.03 Oakland Pulmonary Disease Center 01/17/1995 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Regional Neonatal Intensive Childrens Hospital And 7.12.14 Oakland Care Unit 11/01/1984 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCSF Benioff Children's Hospital Childrens Hospital And 7.15.03 Oakland Hemophilia Center 12/03/1986 Conditional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.16.02 Oakland Hematology/Oncology Center 01/08/1975 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.17.06 Oakland Sickle Cell Center 06/09/1986 Conditional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.19.14 Oakland Bone Marrow Transplant Center 01/01/2004 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Gastroenterology and Nutrition Childrens Hospital And 7.23.17 Oakland Center 06/01/1996 Full Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.25.13 Oakland Pediatric Intensive Care Unit 11/01/1984 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Infectious Diseases and Childrens Hospital And 7.26.06 Oakland Immunologic Disorders 09/28/1988 Conditional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Neonatal Extra-Corporeal Childrens Hospital And 7.29.02 Oakland Membrane Oxygenation (ECMO) 03/12/1989 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Communication Disorders Center 7.35.34 Oakland Type C 01/11/2000 Full Alameda 1003961251 Childrens Hospital Medical Childrens Hosp Research 747 52nd Street (951) 679-6858
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.36.3 Oakland Cochlear Implants 09/18/1998 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCSF Benioff Children's Hospital Childrens Hospital And 7.37.06 Oakland HRIF - Regional 09/10/1998 Provisional Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital Communication Disorders Center 7.35.151 Oakland At Walnut Creek Type C 05/05/2014 Full Contra Costa 1003961251 Childrens Hospital Medical Childrens Hosp Research 747 52nd Street (951) 679-6858
Oakland CA 94609
UCSF Benioff Children's Hospital Childrens Hospital And 7.20.30 Oakland Hypertonicity miscellaneous 09/16/2013 Full Alameda 1003961251 Childrens Hospital Medical Resea 747 52nd Street (510) 428-3000
Oakland CA 94609
UCSF Benioff Children's Hospital San 7.02.12 San Francisco Cardiac Center 12/12/2019 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.03.14 San Francisco Craniofacial Center 02/10/1987 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.05.43 San Francisco Rehabilitation Center 04/20/2007 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Myelomeningocele (Spina Bifida) San 7.08.02 San Francisco Center 01/01/1988 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.09.14A San Francisco Metabolic Center 04/15/1981 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.09.15B San Francisco Endocrine Center 04/19/1984 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.10.05 San Francisco Renal Center 06/15/1982 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCSF Benioff Children's Hospital Cystic Fibrosis and Other San 7.11.04 San Francisco Pulmonary Disease Center 03/10/1982 Conditional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Regional Neonatal Intensive San 7.12.04 San Francisco Care Unit 02/26/1982 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.15.02 San Francisco Hemophilia Center 03/08/1982 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.16.03 San Francisco Hematology/Oncology Center 07/01/2005 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.17.25 San Francisco Sickle Cell Center 01/01/2004 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.19.08 San Francisco Bone Marrow Transplant Center 01/01/1987 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.21.1 San Francisco Prosthetics and Orthotics Facility 03/01/2005 Full Francisco UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143-2204
UCSF Benioff Children's Hospital Gastroenterology and Nutrition San 7.23.04 San Francisco Center 10/06/2004 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Specified Inherited Neurologic San 7.24.11 San Francisco Disease Center 12/16/2011 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.25.05 San Francisco Pediatric Intensive Care Unit 03/04/2005 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
UCSF Benioff Children's Hospital Infectious Diseases and San 7.26.05 San Francisco Immunologic Disorders 07/14/2003 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.28.04 San Francisco Liver Transplant Center 04/01/1989 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Neonatal Extra-Corporeal San 7.29.09 San Francisco Membrane Oxygenation (ECMO) 05/07/1990 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Heart and Lung Transplant San 7.31.07 San Francisco Center 01/12/1998 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital Communication Disorders Center San 7.35.66 San Francisco Type C 07/27/2000 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.36.09 San Francisco Cochlear Implants 08/31/2010 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.37.19 San Francisco HRIF - Regional 03/04/2004 Conditional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.20.39 San Francisco Life Center miscellaneous 12/09/2016 Full Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Benioff Children's Hospital San 7.20C.1 San Francisco Rheumatology miscellaneous 12/13/2004 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
UCSF Medical Center-Adult Bone San 7.19.9 Marrow Transplant Center Bone Marrow Transplant Center 01/01/1987 Provisional Francisco 1457450116 UCSF Medical Center Regents of Univ of Ca 505 Parnassus Avenue (415) 476-1000
San Francisco CA 94143
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Communication Disorders Center 7.33.81 Ukiah Hearing Care Type A 11/01/2004 Full Mendocino 1679680417 Andrus, Gary W Andrus, Gary W 1165 S Dora Street (707) 468-0400
Suite B2
Ukiah CA 95482-6353
University of The Pacific Hearing Communication Disorders Center San 7.35.163 And Balance Center Type C 06/10/2019 Full Francisco 1316344104 University of The Pacific University of The Pacific 155 5th Street (415) 780-2001
Suite 250
San Francisco CA 94103-2919
7.02.17 Valley Children's Hospital Cardiac Center 10/16/1984 Full Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.03.09 Valley Children's Hospital Craniofacial Center 12/03/1990 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.05.33 Valley Children's Hospital Rehabilitation Center 12/15/1986 Conditional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Myelomeningocele (Spina Bifida) 7.08.06 Valley Children's Hospital Center 06/24/1976 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.09.08A Valley Childrens' Hospital Metabolic Center 12/21/1994 Full Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.09.08B Valley Children's Hospital Endocrine Center 03/10/1980 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.10.21 Valley Children's Hospital Renal Center 01/01/1998 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Cystic Fibrosis and Other 7.11.02 Valley Children's Hospital Pulmonary Disease Center 07/20/1992 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Regional Neonatal Intensive 7.12.20 Valley Children's Hospital Care Unit 03/12/1981 Conditional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.15.16 Valley Children's Hospital Hemophilia Center 07/30/1981 Full Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.16.19 Valley Children's Hospital Hematology/Oncology Center 03/17/1987 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.17.23 Valley Children's Hospital Sickle Cell Center 12/01/1998 Conditional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Gastroenterology and Nutrition 7.23.14 Valley Children's Hospital Center 07/01/1992 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
7.25.11 Valley Children's Hospital Pediatric Intensive Care Unit 12/04/2002 Full Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Communication Disorders Center 7.35.5 Valley Children's Hospital Type C 05/02/2001 Full Madera 1700949336 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93638-8761
7.37.03 Valley Children's Hospital HRIF - Regional 03/12/1981 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Valley Children's Hospital At Saint Community Neonatal Intensive 7.13.101 Agnes Medical Center Care Unit 06/08/2015 Full Fresno 1205845567 Saint Agnes Medical Center Saint Agnes Medical Center 1303 E Herndon Avenue (559) 450-3000
Fresno CA 93720-3309
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SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Valley Children's Hospital 7.20.11 Neuromuscular miscellaneous 02/24/1983 Provisional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Valley Children's Hospital 7.20.03 Rheumatology miscellaneous 06/01/1997 Conditional Madera 1891858429 Valley Childrens Hospital Valley Childrens Hospital 9300 Valley Childrens Place (559) 353-3000
Madera CA 93636-8761
Community Neonatal Intensive 7.13.05 Valley Presbyterian Hospital Care Unit 01/01/1999 Provisional Los Angeles 1578529285 Valley Presbyterian Hosp Valley Presbyterian Hosp 15107 Vanowen Street (818) 782-6600
Van Nuys CA 91405-4597
7.38.04 Valley Presbyterian Hospital HRIF - Community 01/01/1999 Provisional Los Angeles 1578529285 Valley Presbyterian Hosp Valley Presbyterian Hosp 15107 Vanowen Street (818) 782-6600
Van Nuys CA 91405-4597
Ventura County Medical 7.04.02 Ventura County Medical Center Cleft Palate Center 03/15/1994 Full Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Ventura County Medical 7.09.38B Ventura County Medical Center Endocrine Center 06/16/2015 Full Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Community Neonatal Intensive 7.13.28 Ventura County Medical Center Care Unit 01/01/1993 Full Ventura Ventura Co Medical Ctr Ventura Co 3291 Loma Vista Road (805) 648-9556
Ventura CA 93003-3099
miscellaneous - Rheumatology Ventura County Medical 7.20.38 Ventura County Medical Center Center 03/02/2016 Full Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Gastroenterology and Nutrition Ventura County Medical 7.23.24 Ventura County Medical Center Center 03/02/2016 Full Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Ventura County Medical 7.38.23 Ventura County Medical Center HRIF - Community 01/01/1993 Provisional Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
9/25/21 6:58 PM Page 80 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Ventura County Medical Center Ventura County Medical 7.20.40 Neurology miscellaneous 04/29/2016 Full Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Ventura County Medical Center Ventura County Medical 7.20.42 Opthamology miscellaneous 06/01/2016 Provisional Ventura 1629167457 County of Ventura Cente 300 Hillmont Avenue (805) 652-6000
Ventura CA 93003
Communication Disorders Center 7.33.14 Ventura Hearing Center Type A 10/01/2001 Provisional Ventura 1790823011 Leamy, Donald P Ma Leamy, Donald P Ma 2674 E Main Street (805) 643-4219
Suite I
Ventura CA 93003-2800
Intermediate Neonatal Intensive 7.14.08 Washington Hospital Care Unit 04/22/1997 Provisional Alameda 1679624407 Washington Hosptial Washington Hospital 2000 Mowry Avenue (415) 797-1111
Fremont CA 94538-1746
Intermediate Neonatal Intensive 7.14.71 Watsonville Community Hospital Care Unit 01/14/2005 Full Santa Cruz 1710958228 Watsonville Hosp Corp Watsonville Comm Hosp 75 Neilson Street (831) 763-6040
Watsonville CA 95076-2468
Communication Disorders Center Woodland Memorial 7.33.01 Woodland Memorial Hospital Type A 11/17/2009 Full Yolo 1922116037 Dignity Health Hospital 1325 Cottonwood Street (530) 662-3961
Woodland CA 95695-5131
Zuckerberg San Francisco General Community Neonatal Intensive San 7.13.04 Hospital And Trauma Center Care Unit 02/18/1997 Full Francisco San Francisco Gen Hosp San Francisco Gen Hosp 1001 Potrero Avenue (415) 821-8200
San Francisco CA 94110-3594
Zuckerberg San Francisco General San 7.17.05 Hospital And Trauma Center Sickle Cell Center 05/12/1994 Conditional Francisco San Francisco Gen Hosp San Francisco Gen Hosp 1001 Potrero Avenue (415) 821-8200
San Francisco CA 94110-3594
Zuckerberg San Francisco General San 7.21.03 Hospital And Trauma Center Prosthetics and Orthotics Facility 02/05/2003 Provisional Francisco San Francisco Gen Hosp San Francisco Gen Hosp 1001 Potrero Avenue (415) 821-8200
San Francisco CA 94110-3594
9/25/21 6:58 PM Page 81 of 82
SCC # Center Name SCC Type Eff Dt Facility County NPI Legal Name Business Name Address Phone
Zuckerberg San Francisco General Infectious Diseases and San 7.26.04 Hospital And Trauma Center Immunologic Disorders 06/13/1988 Conditional Francisco San Francisco Gen Hosp San Francisco Gen Hosp 1001 Potrero Avenue (415) 821-8200
San Francisco CA 94110-3594
Zuckerberg San Francisco General Communication Disorders Center San 7.33.129 Hospital And Trauma Center Type A 08/20/2015 Full Francisco 1083648810 San Francisco Gen Hosp San Francisco Gen Hosp 1001 Potrero Avenue (415) 206-8455
San Francisco CA 94110-3594
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