NPIMap

Organization Active NPI

Evonne'S Residential Care Facility

  • Assisted Living Facility
  • San Jose, CA
National Provider Identifier
1356152292
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EVONNE'S RESIDENTIAL CARE FACILITY
Practice address
2719 Penitencia Creek Rd
San Jose, CA 95132-2923
Phone
(408) 770-2115
NPI assigned
Jan 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Evonne Evien, RNNPI 1992516835
Title
Ceo
Phone
(408) 702-7325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

2719 Penitencia Creek Rd
San Jose, CA 95132-2923

Mailing address

2719 Penitencia Creek Rd
San Jose, CA 95132-2923
Phone (408) 770-2115

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1356152292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 PENITENCIA CREEK RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322923",
            "telephone_number": "408-770-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 PENITENCIA CREEK RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322923",
            "telephone_number": "408-770-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVONNE'S RESIDENTIAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-19",
        "status": "A",
        "authorized_official_last_name": "EVIEN",
        "authorized_official_first_name": "EVONNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-702-7325",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.