KAISER FOUNDATION HOSPITAL-MANTECA DPSNF
NPI 1154496867
Skilled Nursing Facility in Manteca, CA

Active since November 21, 2006CLIA Certified · 2 labs
1777 W YOSEMITE AVE, MANTECA, CA 95337(209) 825-3625(209) 825-3627 Get Directions Write a Review

NPPES record last updated: April 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kaiser Foundation Hospital-manteca Dpsnf NPPES

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

KAISER FOUNDATION HOSPITAL-MANTECA DPSNF (NPI 1154496867) is a healthcare organization registered as a skilled nursing facility in Manteca, California and active in the NPI registry since November 2006. The organization holds 2 active CLIA laboratory certificates and lists Deborah Friberg, Sr. Vp/area Manager, as its authorized official.

NPPES Registry Identity

NPI1154496867
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameKAISER FOUNDATION HOSPITALS
Location Address1777 W YOSEMITE AVEManteca, CA 95337-5130
Mailing Address1777 W Yosemite AveManteca, CA 95337-5130 · (209) 825-3625 · Fax (209) 825-3627
Fax(209) 825-3627
Organization SubpartNo
Authorized OfficialDeborah FribergSr. Vp/area Manager · (209) 735-4146
Enumeration DateNovember 21, 2006
Last NPPES UpdateApril 22, 2021
NPPES CertifiedApril 22, 2021
NPI 1154496867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 030000393
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.
1777 W YOSEMITE AVE, Manteca, CA 95337

Other Names 1

Doing Business AsKaiser Foundation Hospital-manteca Dpsnf

Other Identifiers 3

MedicaidLTC55601HCA
MedicaidGR0093734CA
MedicaidLTC70075HCA

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 05D1046264

Kaiser Foundation Hospital Manteca · Manteca, CA
Active · expires Oct 3, 2027
CLIA Number05D1046264
Laboratory TypeHospital
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorYafei Ren
Laboratory Phone(209) 735-6552
Laboratory LocationKaiser Foundation Hospital Manteca1777 West Yosemite Ave, Manteca, CA 95337
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Accreditation 05D0610000

Kaiser Foundation Hospital Manteca Laboratory · Manteca, CA
Active · expires Feb 27, 2027
CLIA Number05D0610000
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Caishu Deng
Laboratory Phone(209) 735-6508
Laboratory LocationKaiser Foundation Hospital Manteca Laboratory1777 W Yosemite Ave, Manteca, CA 95337
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
1777 W YOSEMITE AVE
MANTECA, CA 95337
Pharmacist
1777 W YOSEMITE AVE
MANTECA, CA 95337
Respiratory Therapist, Certified
1777 W YOSEMITE AVE
MANTECA, CA 95337
Dietitian, Registered
1777 W YOSEMITE AVE
MANTECA, CA 95337
Emergency Medicine
1777 W YOSEMITE AVE
MANTECA, CA 95337
Registered Nurse (Diabetes Educator)
1777 W YOSEMITE AVE
MANTECA, CA 95337
Respiratory Therapist, Certified
1777 W YOSEMITE AVE
MANTECA, CA 95337
Respiratory Therapist, Certified
1777 W YOSEMITE AVE
MANTECA, CA 95337

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 Kaiser Foundation Hospitals's NPI number?

The NPI number for Kaiser Foundation Hospitals is 1154496867. It was assigned to this organization in the NPPES registry on November 21, 2006. The provider is doing business as Kaiser Foundation Hospital-Manteca Dpsnf.

Where is Kaiser Foundation Hospitals located?

Kaiser Foundation Hospitals is located at 1777 W Yosemite Ave, Manteca, CA 95337. The listed phone number is (209) 825-3625.

What is Kaiser Foundation Hospitals's specialty?

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

Does Kaiser Foundation Hospitals hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Kaiser Foundation Hospitals was last updated on April 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.