Healthcare Provider Details

I. General information

NPI: 1508720327
Provider Name (Legal Business Name): KINGS PEAK HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 KINGS PEAK CT
ROSEVILLE CA
95747-5986
US

IV. Provider business mailing address

1220 HORTON LN
ROSEVILLE CA
95747-9521
US

V. Phone/Fax

Practice location:
  • Phone: 925-262-6323
  • Fax:
Mailing address:
  • Phone: 925-262-6323
  • Fax:

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: JULIE MALITSKIY
Title or Position: ADMINISTRATOR
Credential:
Phone: 925-262-6323