Healthcare Provider Details

I. General information

NPI: 1952908709
Provider Name (Legal Business Name): SAXENA FAMILY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3486 MONROE AVE
LAFAYETTE CA
94549-4521
US

IV. Provider business mailing address

765 TRAVISO CIR
LIVERMORE CA
94550-7159
US

V. Phone/Fax

Practice location:
  • Phone: 925-283-2555
  • Fax:
Mailing address:
  • Phone: 408-892-0729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SAURABH SAXENA
Title or Position: PRESIDENT
Credential:
Phone: 408-892-0729