Healthcare Provider Details

I. General information

NPI: 1740207455
Provider Name (Legal Business Name): SILVER OAK HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

788 HOLMES ST
LIVERMORE CA
94550-4229
US

IV. Provider business mailing address

788 HOLMES ST
LIVERMORE CA
94550-4229
US

V. Phone/Fax

Practice location:
  • Phone: 925-447-2280
  • Fax: 925-447-6220
Mailing address:
  • Phone: 925-447-2280
  • Fax: 925-447-6220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number140000658
License Number StateCA

VIII. Authorized Official

Name: MRS. ANELLI P. STAMM
Title or Position: LICENSEE
Credential: RN
Phone: 925-447-2280