Organization Active NPI

Fernwood Care Facility LLC

  • Assisted Living Facility
  • Santa Rosa, CA
National Provider Identifier
1619832193
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
FERNWOOD CARE FACILITY LLC
Practice address
116 Fernwood CT
Santa Rosa, CA 95401-6070
Phone
(707) 321-3711
NPI assigned
Dec 17, 2025
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Antonio Gonzales Cruz
Title
Licensee
Phone
(707) 321-3711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

116 Fernwood CT
Santa Rosa, CA 95401-6070

Mailing address

116 Fernwood CT
Santa Rosa, CA 95401-6070
Phone (707) 321-3711

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1619832193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 FERNWOOD CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016070",
            "telephone_number": "707-321-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 FERNWOOD CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016070",
            "telephone_number": "707-321-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNWOOD CARE FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "GONZALES",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "707-321-3711"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.