Angel Prestige Residential Care, LLC

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

RN41086 Issued in NV

Legal business name

ANGEL PRESTIGE RESIDENTIAL CARE, LLC

Practice address

3305 Marcel Court
San Jose, CA 95135

Phone

(408) 440-0920

NPI assigned

Dec 30, 2011

Last updated

Jan 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hermando Esguerra

Title

Administrator

Phone

(408) 568-0615

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace Valenton Esguerra, RN

  • Administrator Registered Nurse
  • Las Vegas, NV
  • NPI 1598012809
  NPD (past)

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1205106770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 MARCEL COURT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95135",
            "telephone_number": "408-440-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 MARCEL COURT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95135",
            "telephone_number": "408-440-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL PRESTIGE RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "ESGUERRA",
        "authorized_official_first_name": "HERMANDO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "408-568-0615"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NV",
            "license": "4185AGC-6",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NV",
            "license": "3220AGC-13",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NV",
            "license": "RN41086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Joseph Anesi
• Kenneth Ang
• Samantha Ang, PA-C
• Neeti Angal
• Angel Behavioral Path LLC
• Lizbeth Angel
• Jarren Angeles
• Maryanne Manetta Angeles, LVN
• Monica Juliana Angeles
• Rachel Angeley

• Rehabilitation Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.