Grancare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

314000000 Issued in CA

Legal business name

GRANCARE LLC

Practice address

1900 Church LN
San Pablo, CA 94806-3708

Phone

(510) 235-5514

NPI assigned

Feb 7, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea Saavedra

Title

Director of Accounts Receivable

Phone

(707) 208-1940

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Creekside Healthcare Center Doing business as

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1811969355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CHURCH LN",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063708",
            "telephone_number": "510-235-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CHURCH LN",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063708",
            "telephone_number": "510-235-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "SAAVEDRA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "707-208-1940",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "314000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC05099I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Petra Maricia Gonzales
• Stephanie G Gonzalez-Fierros
• Merton Bernard Goode, MD
• Alonzo Donell Govain Sr., COUNSELOR
• Eleonora Granados
• Grancare LLC
• Yolanda Renea Graves, SUDCC II
• Linda Wright Green
• Rachel Leigh Greenberg
• Pablo Ivan Guevara, M.D.

• All providers in San Pablo, CA
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.