Healthcare Provider Details

I. General information

NPI: 1336504026
Provider Name (Legal Business Name): CAREMERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 08/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 N PATTERSON AVE
SANTA BARBARA CA
93111-1113
US

IV. Provider business mailing address

163 TECHNOLOGY DR STE 200
IRVINE CA
92618-2486
US

V. Phone/Fax

Practice location:
  • Phone: 805-683-1995
  • Fax: 805-683-4793
Mailing address:
  • Phone: 949-794-0787
  • Fax: 949-261-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number425801991
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number425801990
License Number StateCA

VIII. Authorized Official

Name: SEAN SHEA
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 617-688-5251