NPIMap

Organization Active NPI

GHC of Sunnyvale, LLC

  • Skilled Nursing Facility
  • Sunnyvale, CA
National Provider Identifier
1982608303
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
220000428 Issued in CA
Legal business name
GHC OF SUNNYVALE, LLC
Practice address
797 E Fremont Ave
Sunnyvale, CA 94087-2805
Phone
(408) 738-4880
Fax
(408) 738-1946
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Lois Mastrocola
Title
Chief Financial Officer
Phone
(714) 241-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 220000428 CA Primary

Addresses

Primary practice location

797 E Fremont Ave
Sunnyvale, CA 94087-2805

Mailing address

797 E Fremont Ave
Sunnyvale, CA 94087-2805
Phone (408) 738-4880

Other identifiers 1

IdentifierTypeStateIssuer
LTC55790FMedicaidCA

Other names 1

  • Cedar Crest Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041015000246 CA Part A Provider - Skilled Nursing Facility 1951361708 Practice locations: Sunnyvale, CA

Skilled nursing facility certification: CCN 555790

Legal name
GHC OF SUNNYVALE, LLC
Doing business as
CEDAR CREST NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 9, 2002
Last certification
Mar 29, 2024
Beds
99
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Life Generations Healthcare, LLC
Organization structure
LLCProprietary
Incorporated
May 31, 2000 in CA
Enrollment address
797 E Fremont Ave
Sunnyvale, CA 94087-2805
Nursing home name
CEDAR CREST NURSING AND REHABILITATION CENTER
Affiliated entity
GENERATIONS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cedar Crest Nursing and Rehabilitation CenterCCN 555790
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 9, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9987.1 residents per day on average
Chain
Generations Healthcare27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0664441GHC of Sunnyvale, LLC Dba Cedar Crest797 E Fremont Ave, Sunnyvale, CA 94087Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lois a Mastrocola Individual 5% Or Greater Indirect Ownership InterestChief Financial Officer Feb 1, 1998 9.18%
Corporate OfficerChief Financial Officer Feb 1, 1998
Corporate DirectorChief Financial Officer Feb 1, 1998
W-2 Managing Employee Sep 20, 2023
Thomas Olds Individual 5% Or Greater Indirect Ownership InterestCeo/President Feb 1, 1998 78.13%
Corporate OfficerCeo/President Feb 1, 1998
Corporate DirectorCeo/President Feb 1, 1998
Fred Smith Individual 5% Or Greater Indirect Ownership Interest Feb 1, 1998 12.69%
Life Generations Healthcare, LLC Organization, Santa Ana, CA LLC, For-profit 5% Or Greater Direct Ownership Interest May 1, 2000 100%
Bmo Bank National Association Organization, Chicago, IL Financial institution 5% Or Greater Security Interest Sep 20, 2023

Facilities with the same owner 27

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

View all 27

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1982608303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 E FREMONT AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872805",
            "telephone_number": "408-738-4880",
            "fax_number": "408-738-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 E FREMONT AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940872805",
            "telephone_number": "408-738-4880",
            "fax_number": "408-738-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHC OF SUNNYVALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "MASTROCOLA",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "714-241-5600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "220000428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55790F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cedar Crest Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.