Healthcare Provider Details

I. General information

NPI: 1609713296
Provider Name (Legal Business Name): LIVERMORE CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 PERIDOT DR.
LIVERMORE CA
94550
US

IV. Provider business mailing address

4555 HOPYARD RD. C-17
PLEASANTON CA
94588
US

V. Phone/Fax

Practice location:
  • Phone: 510-695-3017
  • Fax:
Mailing address:
  • Phone: 510-695-3017
  • Fax:

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: MISS MADEENA SIDDIQI
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 510-695-3017