Active NPI
Sarah Xiong
- Custodial Care Facility
- Elk Grove, CA
National Provider Identifier
1629754973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Custodial Care Facility
- License
- 342701130
- Practice address
- 9823 Gavirate Way
Elk Grove, CA 95757-3035 - Phone
- (510) 916-9065
- NPI assigned
- Jun 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | 342701130 | CA | Primary |
Addresses
Primary practice location
9823 Gavirate Way
Elk Grove, CA 95757-3035
Mailing address
7300 Greenville PL
Castro Valley, CA 94552-5257
Phone (510) 414-7828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 342701130 | CA | MD | Custodial Care Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1629754973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 GREENVILLE PL",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945525257",
"telephone_number": "510-414-7828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9823 GAVIRATE WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957573035",
"telephone_number": "510-916-9065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XIONG",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-22",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": "CA",
"license": "342701130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.