MEDICARE: LIVERMORE CARE HOME

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1609713296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVERMORE CARE HOME

Provider Business Mailing Address
First Line	:	4555 HOPYARD RD.
Second Line	:	C-17
City	:	PLEASANTON
State	:	CA
Zip	:	94588
Country	:	US
Telephone Number	:	510-695-3017
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 PERIDOT DR.
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94550
Country	:	US
Telephone Number	:	510-695-3017
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MISS MADEENA SIDDIQI
Credential	:
Telephone Number	:	510-695-3017

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/04/2026

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Directions to “LIVERMORE CARE HOME ” Practice Location

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