NPIMap

Organization Active NPI

Agesong Emeryville Owner, LLC

  • Assisted Living Facility
  • Emeryville, CA
National Provider Identifier
1245568815
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
015601452 Issued in CA
Legal business name
AGESONG EMERYVILLE OWNER, LLC
Doing business as
AgeSong at Bayside Park
Practice address
1440 40TH St
Emeryville, CA 94608-3552
Phone
(510) 594-8800
Fax
(510) 594-9121
NPI assigned
Nov 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Diana Chambers
Title
Executive Director
Phone
(510) 594-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 015601452 CA Primary

Addresses

Primary practice location

1440 40TH St
Emeryville, CA 94608-3552

Mailing address

1440 40TH St
Emeryville, CA 94608-3552
Phone (510) 594-8800

Other names 1

  • AgeSong at Bayside Park Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1245568815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 40TH ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946083552",
            "telephone_number": "510-594-8800",
            "fax_number": "510-594-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 40TH ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946083552",
            "telephone_number": "510-594-8800",
            "fax_number": "510-594-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGESONG EMERYVILLE OWNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "510-594-8800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "015601452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AgeSong at Bayside Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emeryville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.