PACIFIC VILLAS POST ACUTE
NPI 1104491638
Skilled Nursing Facility in Oceanside, CA

Active since May 26, 2021CLIA 05D2301136 · Waiver
3220 THUNDER DRIVE, OCEANSIDE, CA 92056(760) 842-7967 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 20, 2024, Aug 7, 2024, May 26, 2021 (3 updates tracked since 2021).

About Pacific Villas Post Acute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC VILLAS POST ACUTE (NPI 1104491638) is a healthcare organization registered as a skilled nursing facility in Oceanside, California and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through March 20, 2028 and lists John Mitchell, Secretary, as its authorized official.

NPPES Registry Identity

NPI1104491638
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameOCEANSIDEIDENCE OPCO, LLC
Location Address3220 THUNDER DRIVEOceanside, CA 92056
Mailing Address262 N University AveFarmington, UT 84025-2975
Organization SubpartNo
Authorized OfficialJohn MitchellSecretary · (385) 988-3319
Enumeration DateMay 26, 2021
Last NPPES UpdateAugust 20, 20243 updates tracked since enumeration
NPPES CertifiedAugust 20, 2024
NPI 1104491638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
3220 THUNDER DRIVE, Oceanside, CA 92056

Other Names 1

Doing Business AsPacific Villas Post Acute

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2301136

Pacific Villas Post Acute · Oceanside, CA
Active · expires Mar 20, 2028
CLIA Number05D2301136
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMarch 21, 2026
Certificate Expiration DateMarch 20, 2028
Laboratory DirectorYomiyyu Z. Gammada
Laboratory Phone(760) 842-7967
Laboratory LocationPacific Villas Post Acute3220 Thunder Drive, Oceanside, CA 92056
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Oceansideidence Opco, LLC's NPI number?

The NPI number for Oceansideidence Opco, LLC is 1104491638. It was assigned to this organization in the NPPES registry on May 26, 2021. The provider is doing business as Pacific Villas Post Acute.

Where is Oceansideidence Opco, LLC located?

Oceansideidence Opco, LLC is located at 3220 Thunder Drive, Oceanside, CA 92056. The listed phone number is (760) 842-7967.

What is Oceansideidence Opco, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Oceansideidence Opco, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2301136) is associated with this NPI, valid through March 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Oceansideidence Opco, LLC was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.