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NPI Code Detail

MEDICARE: ODD FELLOWS HOME OF CALIFORNIA

MEDICARE: ODD FELLOWS HOME OF CALIFORNIA
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
1314000000XSkilled Nursing Facility220000416CA

Other Identifiers

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

General Provider Information

NPI Number : 1942200225
Entity Type Code : Organization
Provider Name (Legal Business Name) : ODD FELLOWS HOME OF CALIFORNIA
Provider Business Mailing Address
First Line : 14500 FRUITVALE AVE
Second Line :
City : SARATOGA
State : CA
Zip : 95070-6165
Country : US
Telephone Number : 408-741-7000
Fax Number : 408-741-7157
Provider Business Practice Location Address
First Line : 14500 FRUITVALE AVE
Second Line :
City : SARATOGA
State : CA
Zip : 95070-6165
Country : US
Telephone Number : 408-741-7000
Fax Number : 408-741-7157
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SARAH STEL
Credential :
Telephone Number : 408-504-3916
Provider Enumeration Date : 07/28/2005
Last Update Date : 12/11/2025

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Directions to “ODD FELLOWS HOME OF CALIFORNIA ” Practice Location

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