# KAISER FOUNDATION HOSPITALS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KAISER FOUNDATION HOSPITAL-MANTECA DPSNF
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154496867
- **Authorized official:** DEBORAH FRIBERG (SR. VP/AREA MANAGER)
- **Authorized official phone:** (209) 735-4146

## Contact information

- **Practice address:** 1777 W YOSEMITE AVE, MANTECA, CA 95337-5130
- **Practice address phone:** (209) 825-3625
- **Practice address fax:** (209) 825-3627
- **Mailing address:** 1777 W YOSEMITE AVE, MANTECA, CA 95337-5130
- **Mailing address phone:** (209) 825-3625
- **Mailing address fax:** (209) 825-3627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 030000393 | CA | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 04/22/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0093734 | — | CA |
| 05 | — | LTC55601H | — | CA |
| 05 | — | LTC70075H | — | CA |