Millbrae Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MILLBRAE ASSISTED LIVING HOME LLC

Practice address

1001 Hemlock Ave
Millbrae, CA 94030-2046

Phone

(650) 689-5776

NPI assigned

Jun 21, 2021

Organization subpart

No

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

Authorized official

Name

Ginger PO

Title

Ceo

Phone

(949) 648-2737

Specialties & licenses 1

Addresses

Other names 1

• Millbrae Assisted Living Doing business as

Electronic endpoints 1

Interoperability endpoints

• Direct secure messaging: ginger@millbraealf.com

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1508435801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CORPORATE PLAZA DR STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607908",
            "telephone_number": "949-833-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HEMLOCK AVE",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302046",
            "telephone_number": "650-689-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLBRAE ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "PO",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-648-2737"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ginger@MillbraeALF.COM",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 Hemlock Ave",
            "city": "Millbrae",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940302046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Millbrae Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Francisco Tale Martinez II
• Randall Craig Medefesser, DDS
• Joanna Meekay, DDS, MS
• Fabiana Melo, DDS
• Millbrae Assisted Living Center LLC
• Millbrae Care Center LLC
• Millbrae Harmony House, LLC
• Millbrae Manor, Inc
• Millbrae Serra Sanitarium Inc.
• Mosaic Psychotherapy, PC

• Assisted Living Facility in Millbrae, CA
• Providers in Millbrae, 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 Jul 6, 2021; 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.