Active NPI
Hamoa LLC
- Skilled Nursing Facility
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- HAMOA LLC
- Practice address
- 515 E Orangeburg Ave
Modesto, CA 95350-5510 - Phone
- (209) 480-7891
- NPI assigned
- Nov 14, 2019
- 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
- Ryan Williams
- Title
- Managing Member
- Phone
- (916) 945-1248
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
515 E Orangeburg Ave
Modesto, CA 95350-5510
Mailing address
20400 Saratoga Los Gatos Rd
Saratoga, CA 95070-5927
Other names 1
- Valley Skilled Nursing 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 |
|---|---|---|---|---|
| O20201013003154 | CA | Part A Provider - Skilled Nursing Facility | 6507286549 | Practice locations: Modesto, CA |
Skilled nursing facility certification: CCN 055869
- Legal name
- HAMOA LLC
- Doing business as
- VALLEY SKILLED NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 16, 1969
- Last certification
- Mar 14, 2025
- Beds
- 70
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Kalesta Health Care Group
- Organization structure
- LLC
- Incorporated
- Sep 3, 2019 in CA
- Enrollment address
- 515 E Orangeburg Ave
Modesto, CA 95350-5510 - Nursing home name
- VALLEY SKILLED NURSING CENTER
- Affiliated entity
- KALESTA HEALTHCARE GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Valley Skilled Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 16, 1969
- Medicare certification status
- Active
- Certified beds
- 70
- Chain
- Kalesta Healthcare Group
National Provider Directory
National Provider DirectoryLocations
599 Menlo Dr
Ste 200
Rocklin, CA 95765
Phone (619) 203-8616
Ownership & related parties
All disclosed owners & managing parties 20
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 |
|---|---|---|---|
| Ethan D Flake | Corporate Director | Oct 7, 2024 | |
| Operational/Managerial Control | Oct 7, 2024 | ||
| Scott Clawson | 5% Or Greater Indirect Ownership Interest | Oct 1, 2019 | 47.55% |
| Corporate Officer | Oct 1, 2019 | ||
| Ishankumar R Modi | Corporate Director | Nov 4, 2019 | |
| Operational/Managerial Control | Nov 4, 2019 | ||
| Atul Verma | Operational/Managerial Control | Mar 1, 2023 | |
| Adp of the SNF | Sep 30, 2025 | ||
| Zachary Ryan Tyson | Operational/Managerial Control | Oct 1, 2019 | |
| Adp of the SNF | Sep 22, 2025 | ||
| Domonique Fields | Corporate Director | Oct 1, 2019 | |
| Operational/Managerial Control | Oct 1, 2019 | ||
| Scott Clawson | Indirect Ownership Interest | Mar 1, 2021 | 4.9% |
| Ctr Partnership LP | Adp of the SNF | Oct 1, 2019 | |
| Martha Blake | Operational/Managerial Control | Jan 1, 2025 | |
| Eldberto Cardoso | Operational/Managerial Control | Feb 7, 2022 | |
| Ryan Williams | 5% Or Greater Indirect Ownership Interest | Oct 1, 2019 | 47.55% |
| Corporate Officer | Oct 1, 2019 | ||
| Steven Mosher | Corporate Director | Jul 8, 2024 | |
| Operational/Managerial Control | Jul 8, 2024 | ||
| Juana Duran | Operational/Managerial Control | Oct 2, 2019 | |
| Michael Soares | Corporate Director | Mar 1, 2021 | |
| Operational/Managerial Control | Mar 1, 2021 | ||
| Steven Jones | Corporate Officer | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| Texas Capital Bank NA | 5% Or Greater Security Interest | Apr 17, 2025 | 100% |
| Adriana Sagrero Mendoza | Operational/Managerial Control | Nov 28, 2022 | |
| Adp of the SNF | Nov 28, 2022 | ||
| Kalesta Healthcare Group, LLC | 5% Or Greater Direct Ownership Interest | Oct 1, 2019 | 100% |
| Kai Shin Chen | Corporate Officer | Jan 4, 2021 | |
| Operational/Managerial Control | Jan 4, 2021 | ||
| Jeffrey Murray | Corporate Director | Jan 8, 2024 | |
| Operational/Managerial Control | Jan 8, 2024 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physical Therapist
- Rocklin, CA
- NPI 1710299342
Corporate Director, Operational/Managerial Control
-
- Family Medicine Physician
- Stockton, CA
- NPI 1093027989
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 17
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Menlo Park, CA
- NPI 1003451915
Kalesta Healthcare Group, LLC
-
- Skilled Nursing Facility
- Port Angeles, WA
- NPI 1013718170
Kalesta Healthcare Group, LLC
-
- Skilled Nursing Facility
- Bremerton, WA
- NPI 1295536357
Kalesta Healthcare Group, LLC
-
- Skilled Nursing Facility
- Saint Helens, OR
- NPI 1649077405
Kalesta Healthcare Group, LLC
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573689600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1719446400000",
"number": "1124663034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20400 SARATOGA LOS GATOS RD",
"city": "SARATOGA",
"state": "CA",
"postal_code": "950705927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 E ORANGEBURG AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505510",
"telephone_number": "209-480-7891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAMOA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-14",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "916-945-1248"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Valley Skilled Nursing Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Valley Skilled Nursing Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.