MEDICARE: WESTVILLA, INC

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	920000037	CA

General Provider Information

NPI Number	:	1841606845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTVILLA, INC

Provider Business Mailing Address
First Line	:	540 W MONTE VISTA AVE
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-3620
Country	:	US
Telephone Number	:	707-449-3400
Fax Number	:	707-450-0954

Provider Business Practice Location Address
First Line	:	7057 SHOUP AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2335
Country	:	US
Telephone Number	:	818-251-9711
Fax Number	:	510-991-0071

Authorized Official
Title or Position	:	COO
Name	:	TRILOCHAN SINGH
Credential	:
Telephone Number	:	510-468-1909

Provider Enumeration Date	:	07/10/2014
Last Update Date	:	07/10/2014

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