PROVIDENTHEALTHCARE-TAMARACK HOME
NPI 1275879801
Intermediate Care Facility, Intellectual Disabilities in Atwater, CA
NPI Status: Active since December 31, 2012
Contact Information
1553 TAMARACK AVE
ATWATER, CA
ZIP 95301
Phone: (209) 357-2212
Fax: (209) 557-5689
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 05D2121034
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 10-27-2026
About PROVIDENTHEALTHCARE-TAMARACK HOME
This page provides the complete NPI Profile along with additional information for Providenthealthcare-tamarack Home, a provider established in Atwater, California operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1275879801 assigned on December 2012. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Providenthealthcare-tamarack Home. The authorized official of this NPI record is Mr. Jerry R. Tiu (Owner/licensee)
- NPI
- 1275879801
- Provider Legal Name
- PROVIDENT HEALTH CARE INC
- Other Organization Name
- PROVIDENTHEALTHCARE-TAMARACK HOME
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1553 TAMARACK AVE ATWATER, CA 95301
- Location Phone
- (209) 357-2212
- Location Fax
- (209) 557-5689
- Mailing Address
- 1238 CATALINA DR MERCED, CA 95348
- Mailing Phone
- (209) 723-4888
- Mailing Fax
- (209) 557-5689
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-31-2012
- Last Update Date
- 12-31-2012
- Code Navigator
Location Map
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
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
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
- 05D2121034
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- October 28, 2024
- Certificate Expiration Date
- October 27, 2026
- Laboratory Director
- RODRIGO DE ZUBIRIA, MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providenthealthcare-tamarack Home 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 1275879801, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
ATWATER, CA 95301
ATWATER, CA 95301
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275879801, enumerated as an "organization" on December 31, 2012.
The provider is located at 1553 TAMARACK AVE ATWATER, CA 95301 and the phone number is (209) 357-2212.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
