Supra Cares Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPRA CARES INC

Doing business as

Supra Cares Home Health

Practice address

3980 San Pablo Dam Rd Ste 101
El Sobrante, CA 94803-2816

Phone

(510) 775-5670

NPI assigned

Sep 3, 2024

Organization subpart

No

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

Authorized official

Name

Sujan Gautam, FNPNPI 1790499630

Title

Administrator

Phone

(318) 243-5254

Specialties & licenses 1

Addresses

Other names 1

• Supra Cares Home Health Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sujan Gautam, NP

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1790499630
  NPD Authorized official

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1639904428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 N ARLINGTON BLVD",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948064276",
            "telephone_number": "318-243-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 SAN PABLO DAM RD STE 101",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948032816",
            "telephone_number": "510-775-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPRA CARES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "GAUTAM",
        "authorized_official_first_name": "SUJAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-243-5254",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Supra Cares Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Supra Cares Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lael Stimming, LM
• David Christian Stoeckle
• Tiffany Straughter
• Marcella Renee Strickland-Ramsay
• Islam Salah Suliman
• Huda Tahboub
• Laura Tapia Betancourt
• Jennifer Tapia Dimas
• Nevaeh Shadii Taplin-Stanford
• William Gerald Tate Jr.

• Home Health Agency in El Sobrante, CA
• Providers in El Sobrante, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.