MEDICARE: STANFORD SENIOR LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1992649891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANFORD SENIOR LIVING

Provider Business Mailing Address
First Line	:	151 WAVERLY PL
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4551
Country	:	US
Telephone Number	:	510-299-4735
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 WAVERLY PL
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4551
Country	:	US
Telephone Number	:	510-299-4735
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VENUS U STANFORD
Credential	:
Telephone Number	:	510-299-4735

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “STANFORD SENIOR LIVING ” Practice Location

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