Healthcare Provider Details

I. General information

NPI: 1639178429
Provider Name (Legal Business Name): AQUINAS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 PAYNE AVE
SAN JOSE CA
95117-2925
US

IV. Provider business mailing address

3580 PAYNE AVE
SAN JOSE CA
95117-2925
US

V. Phone/Fax

Practice location:
  • Phone: 408-248-7100
  • Fax: 408-248-1856
Mailing address:
  • Phone: 408-248-7100
  • Fax: 408-248-1856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JULITA JAVIER
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 408-248-7100