Healthcare Provider Details

I. General information

NPI: 1932024262
Provider Name (Legal Business Name): PREMIER SENIOR CARE GROUP CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 N SAN TOMAS AQUINO RD
CAMPBELL CA
95008-1628
US

IV. Provider business mailing address

290 N SAN TOMAS AQUINO RD
CAMPBELL CA
95008-1628
US

V. Phone/Fax

Practice location:
  • Phone: 408-378-2535
  • Fax: 408-378-0168
Mailing address:
  • Phone: 408-378-2535
  • Fax: 408-378-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: OLIVIA VELASQUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 408-586-8144