Active NPI
Telecare Corporation
Doing business as Telecare Willow Rock Center
- Psychiatric Hospital
- San Leandro, CA
National Provider Identifier
1053538348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 02016039
- Legal business name
- TELECARE CORPORATION
- Doing business as
- Telecare Willow Rock Center
- Practice address
- 2050 Fairmont Dr
2 BLDG. C-D
San Leandro, CA 94578-1001 - Phone
- (510) 895-5502
- Fax
- (510) 895-7404
- NPI assigned
- Apr 19, 2007
- Last updated
- Mar 1, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lorena Lopez
- Title
- Provider Relations Supervisor
- Phone
- (510) 337-7950
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 02016039 | CA | Primary |
Addresses
Primary practice location
2050 Fairmont Dr
2 BLDG. C-D
San Leandro, CA 94578-1001
Mailing address
1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-1078
Phone (510) 337-7950
Other names 1
- Telecare Willow Rock Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100915000253 | CA | Part A Provider - Hospital | 6901820380 | Practice locations: San Leandro, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1053538348. Details of each certification follow.
Hospital certification: CCN 054149
- Legal name
- TELECARE CORPORATION
- Doing business as
- WILLOW ROCK CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Aug 12, 2011
- Last certification
- Jul 20, 2011
- Beds
- 16
- Ownership / control type
- Private (for profit)
- Organization structure
- Corporation
- Incorporated
- Aug 23, 1965 in CA
- Enrollment address
- 2050 Fairmont Dr
San Leandro, CA 94578-1001 - Hospital subgroups
- Psychiatric
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Gateway To Recovery
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Diego, CA
- NPI 1720164882
6901820380
-
dba Telecare Heritage PHF
- Psychiatric Hospital
- Oakland, CA
- NPI 1881641421
6901820380
Care Compare: Hospital
Medicare Care Compare- Listed as
- Willow Rock Center
- Type
- Psychiatric
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider Directory- Tax ID family
- Telecare Copration
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Telecare Wellness Village MHRC
- Mental Illness Community Based Residential Treatment Facility
- Perris, CA
- NPI 1013820414
-
dba Kearny Vista PSH
- Mental Illness Community Based Residential Treatment Facility
- San Diego, CA
- NPI 1013674068
-
dba Telecare Citrus House
- Mental Illness Community Based Residential Treatment Facility
- Downey, CA
- NPI 1023764727
-
dba Kern CARE Court
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bakersfield, CA
- NPI 1023826419
-
dba Telecare Stephanie House
- Mental Illness Community Based Residential Treatment Facility
- Garden Grove, CA
- NPI 1023882719
-
dba Telecare Aot Renew N B St
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sacramento, CA
- NPI 1023885241
-
- Psychiatric Hospital
- Ceres, CA
- NPI 1033530746
-
dba Kaiser Downey
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bellflower, CA
- NPI 1033688528
-
dba Kaiser ICT Sacramento
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sacramento, CA
- NPI 1053916122
-
dba Villa Fairmont Mental Health Rehabilitation Center
- Mental Illness Community Based Residential Treatment Facility
- San Leandro, CA
- NPI 1073695011
-
dba Kaiser ICT North Bay Hub
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Fairfield, CA
- NPI 1083219521
-
dba Telecare Serenity House CRT
- Mental Illness Community Based Residential Treatment Facility
- San Mateo, CA
- NPI 1083356265
Locations
2050 Fairmont Dr
Bldg Cd
Castro Valley, CA 94578
Phone (510) 895-5502
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Anita Barnes | Corporate Officer | Jan 1, 2020 | |
| Leslie Davis | Corporate Officer | Jan 1, 2019 | |
| W-2 Managing Employee | Jan 1, 2019 | ||
| Lorena Lopez | W-2 Managing Employee | Aug 25, 2015 | 100% |
| Anne L Bakar | 5% Or Greater Direct Ownership Interest | Aug 24, 1980 | 100% |
| Corporate Officer | Aug 24, 1980 | ||
| Corporate Director | Aug 24, 1980 | ||
| W-2 Managing Employee | Aug 24, 1980 |
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Morton Bakar Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Oct 5, 1994 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Morton Bakar Center
- Skilled Nursing Facility
- Hayward, CA
- NPI 1841388451
5% Or Greater Direct Ownership Interest
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1677628800000",
"number": "1053538348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 MARINA VILLAGE PKWY",
"address_2": "SUITE 100",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011078",
"telephone_number": "510-337-7950",
"fax_number": "510-337-7969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 FAIRMONT DR",
"address_2": "2 BLDG. C-D",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781001",
"telephone_number": "510-895-5502",
"fax_number": "510-895-7404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TELECARE CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-19",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A",
"authorized_official_last_name": "LOPEZ",
"authorized_official_first_name": "LORENA",
"authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
"authorized_official_telephone_number": "510-337-7950"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "CA",
"license": "02016039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Telecare Willow Rock Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Telecare Willow Rock Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Leandro, CA
- Lindsay Teitelbaum, M.S. CCC-SLP
- Stephanie Tejada
- Tatiana Maxine Tejeda
- Lidia Tekie, OD
- Bana Tekle
- Telecare Corporation (Villa Fairmont Mental Health Rehabilitation Center)
- Telecare Corporation
- Telecare Corporation (Alameda County Adolescent CSU)
- Telecare Corporation (Alameda County Adolescent CSU Aftercare)
- Jennifer Marie Teng, MD
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.