Individual provider Active NPI

Leilani Dizon Aragon

  • Assisted Living Facility
  • Fair Oaks, CA
National Provider Identifier
1457907255
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
342700350 Issued in CA
Practice address
5929 Spring Glen Dr
Fair Oaks, CA 95628-2729
Phone
(916) 844-7582
NPI assigned
Aug 16, 2019
Last updated
Aug 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 342700350 CA Primary

Addresses

Primary practice location

5929 Spring Glen Dr
Fair Oaks, CA 95628-2729

Mailing address

331 Portico CT
Tracy, CA 95377-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
342700350CAMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Glen Elderly Care Villa Assisted Living Facility CurrentSince Sep 8, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1457907255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 PORTICO CT",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953771107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 SPRING GLEN DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282729",
            "telephone_number": "916-844-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAGON",
        "first_name": "LEILANI",
        "middle_name": "DIZON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "342700350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.