JACOB HEALTH CARE CENTER LP
NPI 1881684900
Skilled Nursing Facility in San Diego, CA

Active since October 28, 2005CLIA 05D0643096 · Waiver
4075 54TH ST, SAN DIEGO, CA 92105(323) 556-0040(323) 556-0048 Get Directions Write a Review

NPPES record last updated: July 25, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jacob Health Care Center Lp NPPES

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

JACOB HEALTH CARE CENTER LP (NPI 1881684900) is a healthcare organization registered as a skilled nursing facility in San Diego, California and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jacob Graff, P, as its authorized official.

NPPES Registry Identity

NPI1881684900
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameJACOB HEALTH CARE CENTER LP
Location Address4075 54TH STSan Diego, CA 92105
Mailing Address4075 54th StSan Diego, CA 92105-2301 · (323) 556-0040 · Fax (323) 556-0048
Fax(323) 556-0048
Organization SubpartNo
Authorized OfficialJacob GraffP · (310) 286-3074
Enumeration DateOctober 28, 2005
Last NPPES UpdateJuly 25, 2018
NPI 1881684900 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 · 090000093
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.

4075 54TH ST, San Diego, CA 92105

Other Identifiers 1

MedicaidZZT055508GCA

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 05D0643096

Jacob Health Care Center LLC · San Diego, CA
Active · expires Aug 31, 2026
CLIA Number05D0643096
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorGregg Garner MD
Laboratory Phone(619) 582-5168
Laboratory LocationJacob Health Care Center LLC4075 54th Street, San Diego, CA 92105
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Skilled Nursing Facility
4075 54TH ST
SAN DIEGO, CA 92105
Registered Nurse
4075 54TH ST
SAN DIEGO, CA 92105
Assisted Living Facility
4075 54TH ST
SAN DIEGO, CA 92105

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 Jacob Health Care Center LP's NPI number?

The NPI number for Jacob Health Care Center LP is 1881684900. It was assigned to this organization in the NPPES registry on October 28, 2005.

Where is Jacob Health Care Center LP located?

Jacob Health Care Center LP is located at 4075 54th St, San Diego, CA 92105. The listed phone number is (323) 556-0040.

What is Jacob Health Care Center LP's specialty?

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

Does Jacob Health Care Center LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0643096) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jacob Health Care Center LP was last updated on July 25, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.