MEDICARE: STANFORD SENIOR CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	385H00000X	Respite Care
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063236453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANFORD SENIOR CARE LLC

Provider Business Mailing Address
First Line	:	151 WAVERLY PL
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4551
Country	:	US
Telephone Number	:	510-299-4735
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 WAVERLY PL
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4551
Country	:	US
Telephone Number	:	510-299-4735
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VENUS U STANFORD
Credential	:	LICENSED HOMECARE
Telephone Number	:	510-299-4735

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	04/17/2026

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