# ST JUDE HOSPITAL YORBA LINDA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST JOSEPH HERITAGE HEALTHCARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497051874
- **Authorized official:** JOHN BENNETT (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (714) 449-4800

## Contact information

- **Practice address:** 3304 RENNER DR, FORTUNA, CA 95540-7102
- **Practice address phone:** (707) 725-9383
- **Practice address fax:** (707) 725-1140
- **Mailing address:** 279 IMPERIAL HWY, SUITE 730, FULLERTON, CA 92835-1041
- **Mailing address phone:** (714) 449-4841
- **Mailing address fax:** (714) 449-4956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 02/02/2011
- **Last updated:** 02/02/2011