Organization Active NPI

Saint Vincent Healthcare Provider, LLC

  • In Home Supportive Care Agency
  • Vallejo, CA
National Provider Identifier
1417830639
Registry record updated Jul 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
SAINT VINCENT HEALTHCARE PROVIDER, LLC
Practice address
253 Voyager Dr
Vallejo, CA 94590-4013
Phone
(707) 392-9948
NPI assigned
Jul 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2025

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

Authorized official

Name
Rolando Untalan GochangcoNPI 1144115759
Title
Managing Member
Phone
(707) 392-9948

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

253 Voyager Dr
Vallejo, CA 94590-4013

Mailing address

253 Voyager Dr
Vallejo, CA 94590-4013
Phone (707) 392-9948

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": "1753488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753488000000",
    "number": "1417830639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 VOYAGER DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904013",
            "telephone_number": "707-392-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 VOYAGER DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904013",
            "telephone_number": "707-392-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT VINCENT HEALTHCARE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-26",
        "last_updated": "2025-07-26",
        "certification_date": "2025-07-26",
        "status": "A",
        "authorized_official_last_name": "GOCHANGCO",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_middle_name": "UNTALAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "707-392-9948"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.