Ethel Gumban

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

415600425 Issued in CA

Practice address

2700 Oakmont Dr
San Bruno, CA 94066-1241

Phone

(650) 583-3496

NPI assigned

Jul 15, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• C & C's Care Home

  • Assisted Living Facility
  • San Bruno, CA
  • NPI 1275921231
  NPD (past)
• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938
  NPD (past)

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1073404208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 OAKMONT DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661241",
            "telephone_number": "650-583-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 OAKMONT DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661241",
            "telephone_number": "650-583-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMBAN",
        "first_name": "ETHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "415600425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Angelo L. Guevara
• Ariel Guevarra
• Wendy Elizabeth Guido
• Victoria Guidry
• Jezreel Ruth Palatino Guion
• Lalaine Gumban
• Lizzete Gumban
• Elizabeth Gunst
• Ziyang Guo
• Liset Gutierrez Barraza

• Assisted Living Facility in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.