Healthcare Provider Details
I. General information
NPI: 1669024121
Provider Name (Legal Business Name): KALINGA CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2019
Last Update Date: 12/20/2023
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1230 VANCOUVER WAY
LIVERMORE CA
94550-6028
US
IV. Provider business mailing address
1230 VANCOUVER WAY
LIVERMORE CA
94550-6028
US
V. Phone/Fax
- Phone: 925-453-6128
- Fax: 925-453-6109
- Phone: 925-453-6128
- Fax: 925-453-6109
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
BERNADET
VIRAY
GUEVARRA
Title or Position: ADMINISTRATOR
Credential: RN, FNP
Phone: 650-576-0836