MEDICARE: MARGUERITE TERRACE

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		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538159769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGUERITE TERRACE

Provider Business Mailing Address
First Line	:	10 KIRK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-2214
Country	:	US
Telephone Number	:	408-729-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 KIRK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-2214
Country	:	US
Telephone Number	:	408-729-2000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MS. LORI MICHELLE APPLEBEE
Credential	:	RN
Telephone Number	:	408-729-2010

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	08/22/2020

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Directions to “MARGUERITE TERRACE ” Practice Location

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