Healthcare Provider Details

I. General information

NPI: 1831185735
Provider Name (Legal Business Name): SHIELDS NURSING CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 CARLSON BLVD
EL CERRITO CA
94530-3907
US

IV. Provider business mailing address

606 ALFRED NOBEL DR
HERCULES CA
94547-1834
US

V. Phone/Fax

Practice location:
  • Phone: 510-525-3212
  • Fax: 510-525-6832
Mailing address:
  • Phone: 510-724-9911
  • Fax: 510-724-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140000276
License Number StateCA

VIII. Authorized Official

Name: MR. WILLIAM M SHIELDS JR.
Title or Position: CEO/PRESIDENT
Credential: ADMINISTRATOR
Phone: 510-724-9911