NPIMap

Organization Active NPI

Creekside Operating Company LP

  • Skilled Nursing Facility
  • San Pablo, CA
National Provider Identifier
1306269386
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
140000547 Issued in CA
Legal business name
CREEKSIDE OPERATING COMPANY LP
Practice address
1900 Church LN
San Pablo, CA 94806-3708
Phone
(510) 235-5514
NPI assigned
Jan 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Authorized official

Name
Mrs. Andrea Saavedra
Title
Regional Financial Analyst
Phone
(707) 208-1940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 140000547 CA Primary

Addresses

Primary practice location

1900 Church LN
San Pablo, CA 94806-3708

Mailing address

1900 Church LN
San Pablo, CA 94806-3708
Phone (510) 235-5514

Other identifiers 1

IdentifierTypeStateIssuer
LTC05099LMedicaidCA

Other names 1

  • Creekside Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161209000815 CA Part A Provider - Skilled Nursing Facility 3779863709 Practice locations: San Pablo, CA

Skilled nursing facility certification: CCN 055099

Legal name
CREEKSIDE OPERATING COMPANY LP
Doing business as
CREEKSIDE HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 11, 1970
Last certification
May 24, 2024
Beds
80
Ownership / control type
Partnership
Multi-facility organization
National Senior Care, Inc.
Organization structure
PartnershipProprietary
Incorporated
Jan 7, 2014 in DE
Enrollment address
1900 Church LN
San Pablo, CA 94806-3708
Nursing home name
CREEKSIDE HEALTHCARE CENTER
Affiliated entity
MARINER HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Creekside Healthcare CenterCCN 055099
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Feb 11, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8070.3 residents per day on average
Chain
Mariner Health Care17 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Grancare LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2015 100%
MHC West Holding Company Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2015 100%
National Senior Care, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2015 100%
GC Holding Company 2 LLC Organization, Atlanta, GA LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2015 99%
Limited Partnership Interest Jun 30, 2015 99%
MHC Holding Company Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2015 100%
Mariner Health Care, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2015 100%
Gurpreet Dhugga Individual Operational/Managerial Control Sep 1, 2022
Adp of the SNF Sep 1, 2022
Creekside Holding Company GP LLC Organization, Atlanta, GA LLC, Holding company, For-profit General Partnership Interest Jun 30, 2015 1%
Emily Grunstein Individual 5% Or Greater Indirect Ownership Interest Feb 6, 2019 100%
Janet Rotich Individual Corporate OfficerAdministrator Jun 30, 2015
Operational/Managerial Control Apr 24, 2000
Adp of the SNF Apr 24, 2000
Navjot Kaur Individual Operational/Managerial Control Feb 9, 2026
Adp of the SNF Feb 9, 2026
Dennis Sarcauga Individual Corporate OfficerPresident Feb 6, 2025
Operational/Managerial Control Feb 6, 2025
Adp of the SNF Feb 6, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1306269386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CHURCH LN",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063708",
            "telephone_number": "510-235-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CHURCH LN",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063708",
            "telephone_number": "510-235-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE OPERATING COMPANY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "SAAVEDRA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "REGIONAL FINANCIAL ANALYST",
        "authorized_official_telephone_number": "707-208-1940",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "140000547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC05099L",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.