Good Samaritan Care Provider LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GOOD SAMARITAN CARE PROVIDER LLC

Practice address

442 Sunset Blvd.
Hayward, CA 94541-3832

Phone

(209) 406-6610

Fax

(209) 729-5777

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Praxedes Bernardo Demesa, LNHA

Title

President

Phone

(209) 406-6610

Specialties & licenses 1

Addresses

Other names 1

• Good Samaritan Healthcare Center-Hayward Doing business as

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1053010850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 SUNSET BLVD.",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413832",
            "telephone_number": "209-406-6610",
            "fax_number": "209-729-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 SUNSET BLVD.",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413832",
            "telephone_number": "209-406-6610",
            "fax_number": "209-729-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN CARE PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "DEMESA",
        "authorized_official_first_name": "PRAXEDES",
        "authorized_official_middle_name": "BERNARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-406-6610",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Healthcare Center-Hayward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mia Gonzalez
• Michelle Gonzalez
• Peter Gonzalez
• Rehanna Michelle Gonzalez
• Sofia Gonzalez
• Robyn J. Goodfellow, MD
• Grant Goodman, MD
• Tori Gordon
• Laqulisha Denise Gould
• Payal Gounder

• Skilled Nursing Facility in Hayward, CA
• Providers in Hayward, 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 Mar 1, 2023; 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.