Organization Active NPI

Hamoa LLC

  • Skilled Nursing Facility
  • Modesto, CA
National Provider Identifier
1124663034
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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

Updated by the provider on Jun 27, 2024

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 055869
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 16, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7052.7 residents per day on average
Chain
Kalesta Healthcare Group19 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Ethan D Flake Individual Corporate DirectorRegional Director of Operations Oct 7, 2024
Operational/Managerial Control Oct 7, 2024
Scott Clawson Individual 5% Or Greater Indirect Ownership InterestManager Oct 1, 2019 47.55%
Corporate OfficerManager Oct 1, 2019
Ishankumar R Modi Individual Corporate DirectorDirector of Therapy Services Nov 4, 2019
Operational/Managerial Control Nov 4, 2019
Atul Verma Individual Operational/Managerial Control Mar 1, 2023
Adp of the SNF Sep 30, 2025
Zachary Ryan Tyson Individual Operational/Managerial Control Oct 1, 2019
Adp of the SNF Sep 22, 2025
Domonique Fields Individual Corporate DirectorDirector of Revenue Management Oct 1, 2019
Operational/Managerial Control Oct 1, 2019
Scott Clawson Individual Indirect Ownership Interest Mar 1, 2021 4.9%
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Oct 1, 2019
Martha Blake Individual Operational/Managerial Control Jan 1, 2025
Eldberto Cardoso Individual Operational/Managerial Control Feb 7, 2022
Ryan Williams Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2019 47.55%
Corporate Officer Oct 1, 2019
Steven Mosher Individual Corporate DirectorDirector of It Services Jul 8, 2024
Operational/Managerial Control Jul 8, 2024
Juana Duran Individual Operational/Managerial Control Oct 2, 2019
Michael Soares Individual Corporate DirectorDirector of Plant Operations Mar 1, 2021
Operational/Managerial Control Mar 1, 2021
Steven Jones Individual Corporate OfficerChief Operating Officer Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Texas Capital Bank NA Organization, Dallas, TX Financial institution 5% Or Greater Security Interest Apr 17, 2025 100%
Adriana Sagrero Mendoza Individual Operational/Managerial Control Nov 28, 2022
Adp of the SNF Nov 28, 2022
Kalesta Healthcare Group, LLC Organization, Rocklin, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 2019 100%
Kai Shin Chen Individual Corporate OfficerController Jan 4, 2021
Operational/Managerial Control Jan 4, 2021
Jeffrey Murray Individual Corporate DirectorClinical Services 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.

Facilities with the same owner 17

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

View all 17

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

Verify at the official NPI Registry.