Healthcare Provider Details

I. General information

NPI: 1003720368
Provider Name (Legal Business Name): SENIOR PATHWAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4008 CHUCKWAGON WAY
ROSEVILLE CA
95747-9636
US

IV. Provider business mailing address

4008 CHUCKWAGON WAY
ROSEVILLE CA
95747-9636
US

V. Phone/Fax

Practice location:
  • Phone: 916-671-0308
  • Fax:
Mailing address:
  • Phone: 916-671-0308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DELANDRAN PILLAY
Title or Position: OWNER
Credential: MPA
Phone: 916-671-0308