NPIMap

GHC of Walnut Creek, LLC

Organization Active NPI Skilled Nursing Facility · Walnut Creek, CA

NPI 1063938470 · NPPES record last updated Aug 5, 2024

Key facts

NPI
1063938470
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
GHC OF WALNUT CREEK, LLC
Practice address
1224 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Phone
(925) 937-7450
NPI assigned
Aug 17, 2017
Organization subpart
No

Authorized official

Name
Robyne Wellborn
Title
Is and Ar Training Manager
Phone
(760) 315-0984

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Pedram Taher, M.D Rheumatology Physician · Walnut Creek, CA · NPI 1669625125
    CMS ownership ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Nursing home

Listed as
Walnut Creek Skilled Nursing & Rehabilitation Cent CCN 056327
Overall star rating
★★☆☆☆ 2 of 5
Health inspections
★★☆☆☆ 2 of 5
Staffing
★★★☆☆ 3 of 5
Quality measures
★★★★☆ 4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1980
Medicare certification status
Active (Provider of Services file)
Certified beds
180 · 128.5 residents per day on average
Chain
Generations Healthcare (27 facilities)

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0684685GHC of Walnut Creek, LLC Dba
1224 Rossmoor Parkway, Walnut Creek, CA 94595		Certificate of waiverAug 31, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Skilled nursing facility certification: CCN 056327

Legal name
GHC OF WALNUT CREEK, LLC
Doing business as
WALNUT CREEK SKILLED NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1980
Last certification
Jan 26, 2024
Beds
180
Ownership / control type
Limited Liability Corporation
Multi-facility organization
LIFE GENERATIONS HEALTHCARE, LLC
Organization structure
LLC · Proprietary
Enrollment address
1224 Rossmoor Pkwy
Walnut Creek, CA 94595-2501
Nursing home name
WALNUT CREEK SKILLED NURSING & REHABILITATION CENTER
Affiliated entity
GENERATIONS HEALTHCARE

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lois a Mastrocola
Individual 		5% Or Greater Indirect Ownership Interest
Cfo		 Jul 20, 2017 9.18%
Operational/Managerial Control Jul 20, 2017
Adp of the SNF Jul 20, 2017
Indirect Ownership Interest Jul 20, 2017 9.18%
Tracie Murray
Individual 		Operational/Managerial Control Nov 1, 2025
Adp of the SNF Nov 1, 2025
Thomas Olds
Individual 		5% Or Greater Indirect Ownership Interest
Ceo		 Jul 20, 2017 78.13%
Operational/Managerial Control Jul 20, 2017
Adp of the SNF Jul 20, 2017
Indirect Ownership Interest Jul 20, 2017 78.13%
Pedram Taher
Individual 		Operational/Managerial Control Sep 1, 2017
Adp of the SNF Sep 1, 2017
Vijay Mhay
Individual 		Operational/Managerial Control Apr 7, 2025
Adp of the SNF Apr 7, 2025
Fred Smith
Individual 		5% Or Greater Indirect Ownership Interest Jul 20, 2017 12.69%
Indirect Ownership Interest Jul 20, 2017 12.69%
Lynish Monis
Individual 		Operational/Managerial Control Feb 8, 2016
Adp of the SNF Feb 8, 2016
Alyssa Gong
Individual 		Operational/Managerial Control Jul 27, 2021
Adp of the SNF Jul 27, 2021
GHC of North-Master, LLC
Organization · Santa Ana, CA
LLC, Owned by another organization or individual 		5% Or Greater Security Interest Sep 1, 2017 100%
Adp of the SNF Sep 29, 2025
Alexandra Karmanova
Individual 		Operational/Managerial Control Jan 6, 2025
Adp of the SNF Jan 6, 2025
Bme Holdco a LLC
Organization · New York, NY
LLC 		5% Or Greater Security Interest Sep 1, 2017 100%
Adp of the SNF Sep 1, 2017
Theragen, LLC
Organization · Santa Ana, CA
LLC 		Operational/Managerial Control Jul 20, 2017
Adp of the SNF Aug 28, 2025
Rose Giron
Individual 		Operational/Managerial Control May 27, 2025
Adp of the SNF May 27, 2025
Life Generations Healthcare, LLC
Organization · Santa Ana, CA
LLC, Chain home office, Owned by another organization or individual 		5% Or Greater Direct Ownership Interest Jul 20, 2017 100%
Operational/Managerial Control Jul 20, 2017
Adp of the SNF Nov 15, 2025
Direct Ownership Interest Jul 20, 2017 100%
Bmo Bank National Association
Organization · Chicago, IL
Financial institution, Owned by another organization or individual 		5% Or Greater Security Interest Oct 6, 2021 100%
Operational/Managerial Control Oct 6, 2021
Adp of the SNF Sep 29, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180221002141 CA Part a Provider - Skilled Nursing Facility 5698036366 Practice locations: Walnut Creek, CA

National Provider Directory

Locations

6 Hutton Centre Dr
Fl 4
Santa Ana, CA 92707

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

1224 Rossmoor Pkwy
Walnut Creek, CA 94595-2501

Mailing address

6 Hutton Centre Dr Ste 400
Santa Ana, CA 92707-8762
Phone (714) 241-5600

Other names

  • Walnut Creek Nursing & Rehabilitation Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 5, 2024.

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1063938470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HUTTON CENTRE DR STE 400",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078762",
            "telephone_number": "714-241-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 ROSSMOOR PKWY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952501",
            "telephone_number": "925-937-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHC OF WALNUT CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "WELLBORN",
        "authorized_official_first_name": "ROBYNE",
        "authorized_official_title_or_position": "IS AND AR TRAINING MANAGER",
        "authorized_official_telephone_number": "760-315-0984"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Walnut Creek Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walnut Creek, CA

All providers in Walnut Creek, CA · Skilled Nursing Facility in California

Sources for this page

Verify at the official NPI Registry.