The Waters Edge

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE WATERS EDGE

Practice address

2401 Blanding Ave
Alameda, CA 94501-1503

Phone

(510) 522-1084

Fax

(510) 748-4289

NPI assigned

Oct 3, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lynn Muserelli

Title

Health Information Manager

Phone

(510) 522-1084

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013904267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BLANDING AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011503",
            "telephone_number": "510-522-1084",
            "fax_number": "510-748-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BLANDING AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011503",
            "telephone_number": "510-522-1084",
            "fax_number": "510-748-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERS EDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUSERELLI",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "HEALTH INFORMATION MANAGER",
        "authorized_official_telephone_number": "510-522-1084",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR18267G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Alameda, CA
• Providers in Alameda, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.