EVANGELINA JACY (NPI# 1003365180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003365180 |
| Entity Type | Individual |
| Full Name | EVANGELINA JACY |
| Practice Address |
1820 Bethany Ave San Jose CA 95132-1514 |
| Mailing Address |
1824 Bethany Ave San Jose CA 95132-1514 |
| Practice Telephone | 4082502568 |
| Practice Fax Number | 4087293282 |
| Mailing Telephone | 4082502568 |
| Mailing Fax Number | 4087293282 |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 435201652 | CA | Nursing & Custodial Care Facilities |
| Street Address |
1820 BETHANY AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95132-1514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902300304 | Pamela Judith Reyes | Technician, Other | 2716 Longford Drive, San Jose, CA 95132 | 2018-03-20 |
| 1972990778 | David Thai | Dentist | 2861 Donizetti Ct., San Jose, CA 95132 | 2015-04-20 |
| 1174964092 | Brandi Marche Brooks | Psychologist | 1866 Half Pence Way, San Jose, CA 95132 | 2013-07-08 |
| 1023314325 | Al R Abad Dental Corporation | Dentist | 2664 Berryessa Road, Suite 212, San Jose, CA 95132 | 2011-02-03 |
| 1134355530 | Hang Thuy Tran | Student in an Organized Health Care Education/Training Program | 3314 Hostetter Road, San Jose, CA 95132 | 2009-06-01 |
| 1144408121 | Ruth Elaine Bristol | Marriage & Family Therapist | 3435 Birchwood, San Jose, CA 95132 | 2008-02-01 |
| 1033328398 | Victoria Bethina Andrada | Dentist | 2542 Berryessa Road, San Jose, CA 95132 | 2007-05-22 |
| 1417179540 | Albert G Seid Dds & Hubert G Seid Dds A Professional Corpation | Dentist | 1239 Piedmont Road, San Jose, CA 95132 | 2007-05-02 |
| 1336269554 | Fernando T Vilale | Dentist | 1333 Piedmont Rd#103, San Jose, CA 95132 | 2007-03-30 |
| 1669513172 | Roberto V Espejo Jr Dds Inc | Dentist | 3278 Noble Ave, San Jose, CA 95132 | 2007-02-08 |
| Find all providers in zip 95132 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528672789 | Half Moon Bay Holdings LLC | Assisted Living Facility | 5425 Mayme Ave, San Jose, CA 95129-4833 | 2020-09-04 |
| 1174020879 | Diya Senior Care Corp | Assisted Living Facility | 276 Clearpark Cir, San Jose, CA 95136-2308 | 2018-04-09 |
| 1912423203 | Ladwig Inc | Assisted Living Facility | 683 Undajon Dr, San Jose, CA 95133-1736 | 2017-08-17 |
| 1376072637 | Lee's Care Home | Assisted Living Facility | 5225 Gallant Fox Avenue, San Jose, CA 95131 | 2017-06-08 |
| 1447787478 | Golden Oak Care, Inc | Assisted Living Facility | 2761 Castleton Dr, San Jose, CA 95148-3509 | 2017-05-22 |
| 1669903647 | Lillette Rosete | Assisted Living Facility | 960 Vermont St, San Jose, CA 95126 | 2017-03-22 |
| 1336684216 | Diana Fontanilla | Assisted Living Facility | 259 Checkers Dr, San Jose, CA 95116-1348 | 2016-12-30 |
| 1407390875 | Saint Anthony's Care Home for The Elderly | Assisted Living Facility | 3258 Evco Ct, San Jose, CA 95127-1502 | 2016-12-05 |
| 1568905958 | Angels Manor Care Home | Assisted Living Facility | 1021 Heatherfield Ln, San Jose, CA 95132-2931 | 2016-12-02 |
| 1609232438 | Kimberly's Elder Kare Kottage | Assisted Living Facility | 2770 Moorpark Ave, San Jose, CA 95128-3153 | 2016-01-08 |
| Find all providers in SAN JOSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.