Organization Active NPI

Fair Oaks Residential Treatment Facility

  • Skilled Nursing Facility
  • Fair Oaks, CA
National Provider Identifier
1043755051
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
550003745 Issued in CA
Legal business name
FAIR OAKS RESIDENTIAL TREATMENT FACILITY
Practice address
7959 Orange Ave
Fair Oaks, CA 95628-5916
Phone
(916) 436-4291
Fax
(916) 436-4338
NPI assigned
Dec 29, 2016
Last updated
Dec 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Mr. Brian Martin
Title
Ceo
Phone
(916) 436-4291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 550003745 CA Primary

Addresses

Primary practice location

7959 Orange Ave
Fair Oaks, CA 95628-5916

Mailing address

7959 Orange Avenue
Fair Oaks, CA 95628-5916
Phone (916) 436-4291

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1043755051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7959 ORANGE AVENUE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285916",
            "telephone_number": "916-436-4291",
            "fax_number": "916-436-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7959 ORANGE AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956285916",
            "telephone_number": "916-436-4291",
            "fax_number": "916-436-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS RESIDENTIAL TREATMENT FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-436-4291",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "550003745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.