Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health System - Southern California

Organization Skilled Nursing Facility · NPI 1770639809

Providence Health System - Southern California is a Skilled Nursing Facility in San Pedro, California. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

1322 W 6th St
San Pedro, CA 90732-3501
Phone: (310) 303-7496
Fax: (310) 303-7575
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X

Record details

NPI number1770639809
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Enrollments · (425) 358-9786
Other names Providence Little Company Of Mary Sub Acute Care Center; Providence Little Company Of Mary Sub Acute Care Center
NPI enumeratedJanuary 25, 2007
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025
Mailing addressPo Box 31001-3017, Pasadena, CA 91110-3017

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