C & C's Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

415600425 Issued in CA

Legal business name

C & C'S CARE HOME

Practice address

2700 Oakmont Dr.
San Bruno, CA 94066

Phone

(650) 228-3777

Fax

(650) 871-8290

NPI assigned

Dec 29, 2014

Organization subpart

No

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

Authorized official

Name

Ethel Gumbam

Title

Licensed/Administrator

Phone

(650) 228-3777

Specialties & licenses 1

Addresses

Practitioners 1

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

• Ethel Gumban

  • Assisted Living Facility
  • San Bruno, CA
  • NPI 1073404208
  NPD (past)

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1275921231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 OAKMONT DR.",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066",
            "telephone_number": "650-228-3777",
            "fax_number": "650-871-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 OAKMONT DR.",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "94066",
            "telephone_number": "650-228-3777",
            "fax_number": "650-871-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & C'S CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "GUMBAM",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_title_or_position": "LICENSED/ADMINISTRATOR",
        "authorized_official_telephone_number": "650-228-3777"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "415600425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Burks
• Nathan Burn
• Lysa Burns
• Jabrael M Butler
• Paula Byrne, BCBA
• C.R.E. Enterprise, Inc.
• Grant Cabato
• Lorraine Vianey Cabral Fabela
• Noel Carcallas Cabrera
• Denise Cachola, PT, DPT

• Assisted Living Facility in San Bruno, CA
• Providers in San Bruno, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.