Camellia Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

347003786 Issued in CA

Legal business name

CAMELLIA ASSISTED LIVING

Practice address

4625 Chicago Ave
Fair Oaks, CA 95628-6034

Phone

(916) 962-7106

Fax

(916) 962-7106

NPI assigned

Nov 27, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Tisa Cadway

Title

Owner

Phone

(650) 207-3667

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385510400000",
    "number": "1487085510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 CHICAGO AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286034",
            "telephone_number": "916-962-7106",
            "fax_number": "916-962-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 CHICAGO AVE",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956286034",
            "telephone_number": "916-962-7106",
            "fax_number": "916-962-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELLIA ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A",
        "authorized_official_last_name": "CADWAY",
        "authorized_official_first_name": "TISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-207-3667",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "347003786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fair Oaks, CA
• Providers in Fair Oaks, 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 27, 2013; 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.