Marymount Villa

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MARYMOUNT VILLA

Practice address

345 Davis St
San Leandro, CA 94577-2796

Phone

(510) 895-5007

NPI assigned

Sep 6, 2021

Organization subpart

No

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

Authorized official

Name

Arjun Bahagat

Title

Owner

Phone

(510) 895-5007

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1630886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630886400000",
    "number": "1508534314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772796",
            "telephone_number": "510-895-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772796",
            "telephone_number": "510-895-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT VILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-06",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A",
        "authorized_official_last_name": "BAHAGAT",
        "authorized_official_first_name": "ARJUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-895-5007"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Martinez
• Tomalikia Tamu Martinez
• Tresa Marie Martinez
• Maru
• Brittney Maryland
• Devon Marzo
• Ceseana Marzouk, M.S., R.D.
• Anthony Joseph Mascarenas
• Jose L. Mascorro Jr., A.S.W.
• Jeffrey Mashburn

• Assisted Living Facility in San Leandro, CA
• Providers in San Leandro, 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 Sep 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.