WEST SACRAMENTO NURSING AND REHABILITATION CENTER
NPI 1104316413
Skilled Nursing Facility in West Sacramento, CA

NPI Status: Active since May 11, 2018

Contact Information

751 ELM STREET
WEST SACRAMENTO, CA
ZIP 95605
Phone: (530) 902-4142

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 05D2181017
  • CLIA Cert. Type: Other - CLHF
  • CLIA Exp. Date: 03-24-2028

About WEST SACRAMENTO NURSING AND REHABILITATION CENTER

This page provides the complete NPI Profile along with additional information for West Sacramento Nursing And Rehabilitation Center, a provider established in West Sacramento, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1104316413 assigned on May 2018. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as West Sacramento Nursing And Rehabilitation Center. The authorized official of this NPI record is Mr. David Manukyan (Administrator)

NPI
1104316413
Provider Legal Name
WEST SACRAMENTO NURSING AND REHABILITATION CENTER
Other Organization Name
WEST SACRAMENTO NURSING AND REHABILITATION CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
751 ELM STREET WEST SACRAMENTO, CA 95605
Location Phone
(530) 902-4142
Mailing Address
751 ELM STREET WEST SACRAMENTO, CA 95605
Mailing Phone
(916) 572-0085
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-11-2018
Last Update Date
09-13-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1313M00000XNursing & Custodial Care Facilities

Nursing Facility/Intermediate Care Facility

(CA)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DAVID MANUKYAN

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(916) 572-0085

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2181017
Facility Type
Other - CLHF
Certificate Effective Date
March 25, 2026
Certificate Expiration Date
March 24, 2028
Laboratory Director
ALEXANDER CHAN MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to West Sacramento Nursing And Rehabilitation Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104316413, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 3 → 6 6 → 12 → 3 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 6 + 1 + 1 + 2 + 4 + 2 + 24 = 47

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1104316413.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104316413, enumerated as an "organization" on May 11, 2018.

The provider is located at 751 ELM STREET WEST SACRAMENTO, CA 95605 and the phone number is (530) 902-4142.

Skilled Nursing Facility with taxonomy code 314000000X.