Shine Place (NPI# 1396374674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1396374674 |
| Entity Type | Organization |
| Organization Name | SHINE PLACE |
| Practice Address |
336 Winewood St San Diego CA 92114-5956 |
| Practice Telephone | 6196006003 |
| Mailing Address |
336 Winewood St San Diego CA 92114-5956 |
| Authorized Official Name | Lecia Icari (OWNER) |
| Authorized Official Telephone | 6196006003 |
| Organization Subpart | No, this organization is not a Subpart |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
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| 1821650300 | Ktre1, LLC | Assisted Living Facility | 3219 Canon St., San Diego, CA 92106 | 2019-07-03 |
| 1245698422 | Kevin Posada | Assisted Living Facility | 3664 Governor Dr, San Diego, CA 92122-2418 | 2016-02-03 |
| 1477922425 | Canyon Hill Senior Home II | Assisted Living Facility | 11075 Polaris Dr, San Diego, CA 92126-4703 | 2015-09-21 |
| 1760851232 | Canyon Hill Senior Home I | Assisted Living Facility | 7241 Canyon Hill Ct, San Diego, CA 92126-2050 | 2015-09-15 |
| 1679957955 | Santa Martha Residential #7 | Assisted Living Facility | 6052 Rancho Mission Rd, Unit 408, San Diego, CA 92108-2355 | 2015-07-16 |
| 1972982213 | Teresita Pedroso | Assisted Living Facility | 7229 Zest St, San Diego, CA 92139-1253 | 2015-05-20 |
| 1902298946 | Stellar Care Inc | Assisted Living Facility | 4518 54th St, San Diego, CA 92115-3527 | 2015-02-27 |
| 1225430580 | Right Choice Senior Living LLC | Assisted Living Facility | 6354 Cascade St, San Diego, CA 92122-2421 | 2014-09-18 |
| Find all providers in SAN DIEGO | ||||
| Street Address |
336 WINEWOOD ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92114-5956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689280422 | Jason Vince Rather | Counselor | 333 Ledgewood Lane, San Diego, San Diego, CA 92114 | 2020-09-17 |
| 1144882622 | Melissa Ratsamy | Peer Specialist | 286 Euclid Ave Project Enable, #102, San Diego, CA 92114 | 2019-07-03 |
| 1285113951 | Janet Miller | Prosthetist | 6662 Charlene Ave, San Diego, CA 92114 | 2018-08-13 |
| 1568828671 | Ceferina Pulgar Ruiz | General Practice | 6809 Freed Manor Lane, San Diego, CA 92114 | 2016-01-05 |
| 1275919227 | Susan Reyes | Registered Nurse | 802a Cardiff Street, San Diego, CA 92114 | 2015-07-31 |
| 1760829097 | Rea Ordono Porciuncula | Registered Nurse | 982 Worthington St., San Diego, CA 92114 | 2013-05-28 |
| 1912170176 | Maxine Whitfield | Specialist | 5844 Mariposa Place, San Diego, CA 92114 | 2008-04-09 |
| 1124210844 | Bahghi Russom Keflezighi | Family Medicine | 220 Euclid Avenue, Suite 40, San Diego, CA 92114 | 2007-08-16 |
| 1982701058 | Mark Leroy Dimry | Pharmacist | 286 N Euclid Ave, Semca Pharmacy, San Diego, CA 92114 | 2006-09-20 |
| 1649241514 | Wendy G Chacon | Pediatrics | 292 Euclid Avenue, #220, San Diego, CA 92114 | 2006-01-30 |
| Find all providers in zip 92114 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.