Healthcare Provider Details

I. General information

NPI: 1376450171
Provider Name (Legal Business Name): LOREDANA CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 AUDREY WAY
ROSEVILLE CA
95661-4403
US

IV. Provider business mailing address

1041 AUDREY WAY
ROSEVILLE CA
95661-4403
US

V. Phone/Fax

Practice location:
  • Phone: 916-841-7065
  • Fax: 530-240-2499
Mailing address:
  • Phone: 916-841-7065
  • Fax: 530-240-2499

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: GETA LOREDANA POP
Title or Position: ADMINISTRATOR
Credential:
Phone: 916-841-7065