NPIMap

Organization Active NPI

Green Pasture Guest Home

  • Adult Care Home Facility
  • Sacramento, CA
National Provider Identifier
1598848269
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
340308522 Issued in CA
Legal business name
GREEN PASTURE GUEST HOME
Practice address
4604 Roosevelt Ave
Sacramento, CA 95820-4520
Phone
(916) 457-3129
NPI assigned
Oct 24, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Gary Tateishi
Title
Administrator
Phone
(916) 457-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 340308522 CA Primary

Addresses

Primary practice location

4604 Roosevelt Ave
Sacramento, CA 95820-4520

Mailing address

4604 Roosevelt Ave
Sacramento, CA 95820-4520
Phone (916) 457-3129

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1598848269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 ROOSEVELT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958204520",
            "telephone_number": "916-457-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 ROOSEVELT AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958204520",
            "telephone_number": "916-457-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PASTURE GUEST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "TATEISHI",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-457-3129"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": "340308522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.