Department of Veterans Affairs of the State of California
NPI 1396165353ActiveOrganization· Skilled Nursing Facility· Redding, CA
Skilled Nursing Facility in Redding, California, registered in NPPES in April 2014. The authorized official on file is Timothy Bouseman, Administrator. Enrolled in Medicare as part a provider - skilled nursing facility and part b supplier - clinic/group practice.
Overview
| NPI | 1396165353 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 17, 2014 |
| Last updated in NPPES | Jul 11, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 550002715 | CA |
| Assisted Living Facility | 310400000X | 455002486 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (CA); Part B Supplier - Clinic/Group Practice (CA) |
|---|
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