Organization Active NPI

Eastbay Hospice Inc

  • Community Based Hospice Care Agency
  • Fairfield, CA
National Provider Identifier
1205418282
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
EASTBAY HOSPICE INC
Practice address
1710 Pennsylvania Ave Ste E-1
Fairfield, CA 94533-3589
Phone
(707) 428-1473
Fax
(707) 428-1276
NPI assigned
Apr 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Cristina R Santillan
Title
Administrator
Phone
(707) 290-1816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1710 Pennsylvania Ave Ste E-1
Fairfield, CA 94533-3589

Mailing address

1710 Pennsylvania Ave Ste E-1
Fairfield, CA 94533-3589
Phone (707) 428-1473

National Provider Directory

National Provider Directory

Locations

1710 Pennsylvania Ave
Ste E1
Fairfield, CA 94533
Phone (707) 428-1473

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1205418282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE STE E-1",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333589",
            "telephone_number": "707-428-1473",
            "fax_number": "707-428-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 PENNSYLVANIA AVE STE E-1",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333589",
            "telephone_number": "707-428-1473",
            "fax_number": "707-428-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTBAY HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "SANTILLAN",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-290-1816"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.