Organization Active NPI

San Leandro Health Care Center, Inc.

  • Skilled Nursing Facility
  • San Leandro, CA
National Provider Identifier
1790850329
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
02 0000097 Issued in CA
Legal business name
SAN LEANDRO HEALTH CARE CENTER, INC.
Practice address
368 Juana Ave
San Leandro, CA 94577-0000
Phone
(510) 357-4015
Fax
(510) 357-3466
NPI assigned
Nov 21, 2006
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Pat Poddatoori
Title
Owner
Phone
(310) 386-3340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 02 0000097 CA Primary

Addresses

Primary practice location

368 Juana Ave
San Leandro, CA 94577-0000

Mailing address

524 Callan Ave
San Leandro, CA 94577-0000
Phone (510) 352-3402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030917000006 CA Part A Provider - Skilled Nursing Facility 5294646303 Practice locations: San Leandro, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790850329. Details of each certification follow.

Skilled nursing facility certification: CCN 056345

Legal name
SAN LEANDRO HEALTH CARE CENTER INC
Doing business as
SAN LEANDRO HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1972
Last certification
Nov 7, 2024
Beds
62
Ownership / control type
Corporation
Most recent change of ownership
Nov 1, 2003
Organization structure
CorporationProprietary
Incorporated
May 13, 2003 in CA
Enrollment address
368 Juana Ave
San Leandro, CA 94577-4811
Nursing home name
SAN LEANDRO HEALTHCARE CENTER
Affiliated entity
PRATAP PODDATOORI

Care Compare: Nursing home

Medicare Care Compare
Listed as
San Leandro Healthcare CenterCCN 056345 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6254.1 residents per day on average
Chain
Pratap Poddatoori6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

368 Juana Ave
San Leandro, CA 94577
Phone (510) 357-4015

524 Callan Ave
San Leandro, CA 94577
Phone (510) 352-3402

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Organization, Pasadena, CA LLC, Medical staffing company, For-profit Adp of the SNF Dec 1, 2021
Organization, Portland, OR LLC, Consulting firm, For-profit Adp of the SNF Jul 7, 2025
Kanika Kakkar Individual Operational/Managerial Control Sep 25, 2023
Adp of the SNF Sep 25, 2023
Lucilla Lopez Individual Operational/Managerial Control Sep 1, 2016
Adp of the SNF Dec 1, 2016
Individual Adp of the SNF Apr 1, 2024
Organization, Atlanta, GA Corporation, Medical provider/supplier, For-profit Adp of the SNF Nov 1, 2003
Terrance J McGregor Individual Operational/Managerial Control Aug 1, 2003
Adp of the SNF Aug 1, 2003
Consuelo M Tamondong Individual Operational/Managerial Control Aug 1, 2013
Adp of the SNF Aug 1, 2013
Carlos Cortez Individual Operational/Managerial Control Sep 9, 2024
Adp of the SNF Sep 9, 2024
Organization, Pleasanton, CA Corporation, Consulting firm, For-profit Adp of the SNF Sep 22, 2025
Porshia C Wynne Individual Operational/Managerial Control Nov 16, 2023
Adp of the SNF Nov 16, 2023
Hilda Padania Individual Operational/Managerial Control Jul 16, 2025
Adp of the SNF Jul 16, 2025
Cheryl Alcantara Individual Operational/Managerial Control Apr 1, 2009
Adp of the SNF Apr 1, 2009
Vy Tran Individual Operational/Managerial Control Nov 18, 2024
Adp of the SNF Nov 18, 2024
Organization, San Leandro, CA LLC, For-profit Adp of the SNF Sep 4, 2003
Norma Andres Individual Operational/Managerial Control Dec 1, 2004
Adp of the SNF Dec 1, 2004
Lara Madamba Individual Operational/Managerial Control Sep 25, 2023
Adp of the SNF Sep 25, 2023
Organization, Brentwood, MO LLC, Medical provider/supplier, For-profit Adp of the SNF Sep 22, 2025
Pratap Poddatoori Individual 5% Or Greater Direct Ownership Interest May 13, 2003 100%
Corporate OfficerPresident/Ceo May 13, 2003 100%
Operational/Managerial Control May 13, 2003
Adp of the SNF May 13, 2003
Marianne Ehrenfeld Individual Operational/Managerial Control Sep 16, 2023
Adp of the SNF Sep 16, 2023
Sylvia Guerrero Individual Operational/Managerial Control Sep 1, 2022
Adp of the SNF Sep 1, 2022
Individual Adp of the SNF Apr 5, 2004
Gurpreet Dhugga Individual Operational/Managerial Control Dec 16, 2019
Adp of the SNF Dec 16, 2019
Hycare Inc Organization, San Leandro, CA Corporation, For-profit Operational/Managerial Control Sep 7, 2006
Adp of the SNF Oct 10, 2025
Organization, Hercules, CA Corporation, Medical provider/supplier, For-profit Adp of the SNF Sep 11, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1790850329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 CALLAN AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945770000",
            "telephone_number": "510-352-3402",
            "fax_number": "510-352-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 JUANA AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945770000",
            "telephone_number": "510-357-4015",
            "fax_number": "510-357-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LEANDRO HEALTH CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "PODDATOORI",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-386-3340"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "02 0000097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.