Live Oak Rest Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIVE OAK REST HOME

Practice address

604 Live Oak Ave
Sebastopol, CA 95472-3363

Phone

(707) 823-7277

Fax

(707) 823-5462

NPI assigned

Nov 8, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Nicholas Leon Ray

Title

Licensee

Phone

(707) 514-6727

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1346958485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 LIVE OAK AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723363",
            "telephone_number": "707-514-6727",
            "fax_number": "707-823-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 LIVE OAK AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723363",
            "telephone_number": "707-823-7277",
            "fax_number": "707-823-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK REST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "707-514-6727",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• James Arthur Lowy, MD
• Xochiquetzal Carmela Lubin-Amaya, LMFT

• Assisted Living Facility in Sebastopol, CA
• Providers in Sebastopol, 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 Nov 8, 2022; 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.