Evergreen Island, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EVERGREEN ISLAND, LLC

Doing business as

Evergreen

Practice address

1710 Mount Diablo Way
Livermore, CA 94551-6937

Phone

(925) 518-8464

Fax

(925) 380-1668

NPI assigned

Nov 30, 2020

Organization subpart

No

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

Authorized official

Name

Miss Janelle M Garcia

Title

Ceo

Phone

(925) 518-8464

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Doing business as

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1730783788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 OBSIDIAN WAY",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945509470",
            "telephone_number": "925-518-8464",
            "fax_number": "925-380-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MOUNT DIABLO WAY",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945516937",
            "telephone_number": "925-518-8464",
            "fax_number": "925-380-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ISLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-518-8464",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohsain Essa, M.D.
• Pedro Luis Estacio, MD
• Parinaz Esteghamat Tehrani, DDS
• Daisy Arabelle Soriben Evangelista, PHARM.D.
• Nancy A. Everett, MD
• Reece Everson, DPM
• Everyday Wellness Therapy
• Eye Candy, L.L.C. (Site for Sore Eyes)
• Celestine Lynn Faeth, MS
• Steven E Faith, O.D.

• Skilled Nursing Facility in Livermore, CA
• Providers in Livermore, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.