Bougainvilleas Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

415600721 Issued in CA

Legal business name

BOUGAINVILLEAS CARE LLC

Doing business as

Bougainvilleas Care Home

Practice address

201 Alta Vista Dr
South San Francisco, CA 94080-5702

Phone

(650) 737-0832

Fax

(650) 737-0834

NPI assigned

Oct 25, 2016

Organization subpart

No

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

Authorized official

Name

Liwayway Pena

Title

Administrator

Phone

(650) 580-5008

Specialties & licenses 1

Addresses

Other names 1

• Bougainvilleas Care Home Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William A Tarran, DPM

  • Podiatrist
  • Pacifica, CA
  • NPI 1952391450
  NPD (past)

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1881146843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ALTA VISTA DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805702",
            "telephone_number": "650-737-0832",
            "fax_number": "650-737-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ALTA VISTA DR",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805702",
            "telephone_number": "650-737-0832",
            "fax_number": "650-737-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUGAINVILLEAS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "LIWAYWAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "650-580-5008"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "415600721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bougainvilleas Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Javeona Janea Boddie
• Lauren Bogue, MS, CGC
• Kiranjyot Boparai, FNP-BC
• Rebecca Borusko, FNP
• Desiree Dominique Botelho
• Chrystal Bowdry, LMFT, LPCC
• Karla Renee Bowles, PH.D., FACMG, CGMB
• Yareli Yurianairi Bowman, OTR/L
• Anna Boyko, RN, NP
• Louise Irene Bracy

• Assisted Living Facility in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.