Organization Active NPI

SP Facility Inc

  • Skilled Nursing Facility
  • San Pablo, CA
National Provider Identifier
1811036957
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SP FACILITY INC
Doing business as
BROOKVUE CARE CENTER
Practice address
13328 San Pablo Ave
San Pablo, CA 94806-3902
Phone
(510) 235-3720
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Jack Easterday
Title
President
Phone
(510) 899-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

13328 San Pablo Ave
San Pablo, CA 94806-3902

Mailing address

13328 San Pablo Ave
San Pablo, CA 94806-3902
Phone (510) 235-3720

Other identifiers 1

IdentifierTypeStateIssuer
ZZR06359IMedicaidCA

Other names 1

  • BROOKVUE CARE CENTER Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1811036957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13328 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063902",
            "telephone_number": "510-235-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13328 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063902",
            "telephone_number": "510-235-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "EASTERDAY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-899-7999"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR06359I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROOKVUE CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Pablo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.