MEDICARE: CARPINTERIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1003451915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARPINTERIA LLC

Provider Business Mailing Address
First Line	:	20400 SARATOGA LOS GATOS RD
Second Line	:
City	:	SARATOGA
State	:	CA
Zip	:	95070-5927
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 CRANE ST
Second Line	:
City	:	MENLO PARK
State	:	CA
Zip	:	94025-4212
Country	:	US
Telephone Number	:	650-484-9186
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	RYAN WILLIAMS
Credential	:
Telephone Number	:	916-945-1248

Provider Enumeration Date	:	11/14/2019
Last Update Date	:	06/27/2024

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Directions to “CARPINTERIA LLC ” Practice Location

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