NPIMap

Organization Active NPI

Tupaz Home # 4

  • Intellectual Disabilities Intermediate Care Facility
  • San Jose, CA
National Provider Identifier
1083825541
Registry record updated Apr 10, 2009
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Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
LTC80077G Issued in CA
Legal business name
TUPAZ HOME # 4
Practice address
888 Clarkston Dr
San Jose, CA 95136-1503
Phone
(408) 266-1521
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2009

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

Authorized official

Name
Beebe Tupaz
Title
Owner
Phone
(408) 377-1622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X LTC80077G CA Primary

Addresses

Primary practice location

888 Clarkston Dr
San Jose, CA 95136-1503

Mailing address

2831 Cortina Way
Union City, CA 94587-1553
Phone (408) 377-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G749

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
TUPAZ HOME #4
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 6, 2017
Last certification
Oct 24, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
888 Clarkston Drive
San Jose, CA 95136

National Provider Directory

National Provider Directory
Tax ID family
Great Endeavors15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1083825541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 CORTINA WAY",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945871553",
            "telephone_number": "408-377-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 CLARKSTON DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951361503",
            "telephone_number": "408-266-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUPAZ HOME # 4",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "TUPAZ",
        "authorized_official_first_name": "BEEBE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-377-1622"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80077G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.