Healthcare Provider Details

I. General information

NPI: 1205316833
Provider Name (Legal Business Name): APTB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 B ST
PETALUMA CA
94952-4028
US

IV. Provider business mailing address

28202 CABOT RD STE 412
LAGUNA NIGUEL CA
92677-1271
US

V. Phone/Fax

Practice location:
  • Phone: 707-765-3030
  • Fax:
Mailing address:
  • Phone: 949-347-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY BRADSHAW
Title or Position: MANAGER
Credential: NHA
Phone: 949-347-7100