Healthcare Provider Details

I. General information

NPI: 1811818230
Provider Name (Legal Business Name): MONTCLAIR VILLA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5602 MONTCLAIR CIR
ROCKLIN CA
95677-3372
US

IV. Provider business mailing address

5602 MONTCLAIR CIR
ROCKLIN CA
95677-3372
US

V. Phone/Fax

Practice location:
  • Phone: 916-850-7479
  • Fax: 916-415-0143
Mailing address:
  • Phone: 916-850-7479
  • Fax: 916-415-0143

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: RADU STEFAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 916-850-7479