Healthcare Provider Details

I. General information

NPI: 1467684654
Provider Name (Legal Business Name): AVANTI INSIEME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38650 MISSION BLVD
FREMONT CA
94536-4391
US

IV. Provider business mailing address

2150 PYRAMID DR
EL SOBRANTE CA
94803-3220
US

V. Phone/Fax

Practice location:
  • Phone: 510-793-3000
  • Fax:
Mailing address:
  • Phone: 510-758-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020000175
License Number StateCA

VIII. Authorized Official

Name: LINDA JOSEPH
Title or Position: OWNER
Credential:
Phone: 510-758-9600