CASA PACIFICA ADHC CENTER - NPI 1609920305 - Clinic/Center in San Diego, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QA0600X and a focus in Adult Day Care.

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About Casa Pacifica Adhc Center NPPES

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

CASA PACIFICA ADHC CENTER (NPI 1609920305) is a healthcare organization registered as an adult day care in San Diego, California and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through April 30, 2027 and lists Luba Vaisman, President Administrator, as its authorized official.

NPPES Registry Identity

NPI1609920305

Entity TypeOrganization

Primary Taxonomy261QA0600X

Legal Business NameJGELT CORPORATION

Location Address1424 30TH ST, SUITE CSan Diego, CA 92154-3421

Mailing Address1424 30th St, Suite CSan Diego, CA 92154-3421 · (619) 424-8181 · Fax (619) 424-8151

Phone(619) 424-8181

Fax(619) 424-8151

Organization SubpartNo

Authorized OfficialLuba VaismanPresident Administrator · (619) 424-8181

Enumeration DateJanuary 22, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1609920305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Day CareAmbulatory Health Care Facilities

Taxonomy Code261QA0600X

1424 30TH ST, San Diego, CA 92154

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Other Names 1

Doing Business AsCasa Pacifica Adhc Center

Other Identifiers 1

MedicaidADU70229FCA

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 05D0985882

Casa Pacifica Adult Day Hlth Care Ctr · San Diego, CA

Active · expires Apr 30, 2027

CLIA Number05D0985882

Laboratory TypeOther

Certificate Effective DateMay 1, 2025

Certificate Expiration DateApril 30, 2027

Laboratory DirectorAbel C. Toledo MD

Laboratory Phone(619) 424-8181

Laboratory LocationCasa Pacifica Adult Day Hlth Care Ctr1424 30th St Ste C, San Diego, CA 92154

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

EPISCOPAL COMMUNITY SERVICES

Early Intervention Provider Agency

1424 30TH ST, SUITE A
SAN DIEGO, CA 92154

San Diego County (619) 565-2650

MRS. ANDREA MEZA CONTRERAS MD

Counselor (Mental Health)