Provider Demographics
NPI:1427181007
Name:DIGNITY HEALTH
Entity type:Organization
Organization Name:DIGNITY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-275-8112
Mailing Address - Street 1:1555 SOQUEL DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1705
Mailing Address - Country:US
Mailing Address - Phone:858-275-8112
Mailing Address - Fax:779-803-8118
Practice Address - Street 1:1555 SOQUEL DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1705
Practice Address - Country:US
Practice Address - Phone:858-275-8112
Practice Address - Fax:779-803-8118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000030314000000X, 273Y00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR00242FMedicaid
CA721561119950650002OtherWPS TRICARE
CA72156111995065A003OtherWPS TRICARE
CAHSC00242FMedicaid
CA721561119950650000OtherWPS TRICARE
CALTC00242FMedicaid
CA721561119950650003OtherWPS TRICARE
CAZZR00242GMedicaid
CAHSM00242FMedicaid
CAHSM00242GMedicaid
CAHSC00242GMedicaid
44BUOtherSANTA CRUZ COUNTY - PES ID
CA721561119OtherIRS
CAHSP40242FMedicaid
CAHSP40242GMedicaid
CAZZZA4401ZOtherBLUE SHIELD
CA721561119950650002OtherWPS TRICARE
CA050242Medicare Oscar/Certification
CAZZZA4401ZOtherBLUE SHIELD
CAHSM00242FMedicaid