Healthcare Provider Details

I. General information

NPI: 1982774329
Provider Name (Legal Business Name): COVIA COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 PINE ST
SAN FRANCISCO CA
94109-0401
US

IV. Provider business mailing address

2185 N CALIFORNIA BLVD STE 215
WALNUT CREEK CA
94596-3566
US

V. Phone/Fax

Practice location:
  • Phone: 415-776-0500
  • Fax: 415-776-5192
Mailing address:
  • Phone: 925-956-7400
  • Fax: 925-407-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number380540292
License Number StateCA

VIII. Authorized Official

Name: DIANA JAMISON
Title or Position: CFO
Credential:
Phone: 925-956-7446