ANGEL PRESTIGE RESIDENTIAL CARE, LLC (NPI# 1205106770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205106770 |
| Entity Type | Organization |
| Organization Name | ANGEL PRESTIGE RESIDENTIAL CARE, LLC |
| Practice Address |
3305 Marcel Court San Jose CA 95135 |
| Practice Telephone | 4084400920 |
| Mailing Telephone | 4084400920 |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2012-01-23 |
| Authorized Official Name | HERMANDO ESGUERRA (ADMINISTRATOR) |
| Authorized Official Telephone | 4085680615 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
4185AGC-6 | NV | Nursing & Custodial Care Facilities |
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
3220AGC-13 | NV | Nursing & Custodial Care Facilities |
| Y | 225400000X | Rehabilitation Practitioner | RN41086 | NV | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3305 MARCEL COURT |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285199497 | Dharitri Pattanaik | Respiratory Therapist, Registered | 2919 Queens Estates Ct, San Jose, CA 95135 | 2019-02-01 |
| 1184170458 | Excel Medicine Inc | General Acute Care Hospital | 4035 Evergreen Village Square, St # 60, San Jose, CA 95135 | 2016-08-28 |
| 1427182179 | Andrew D Harsany Dds Inc | Dentist | 2945 The Villages Parkway, San Jose, CA 95135 | 2007-03-15 |
| 1548377898 | Berna Sanayei | Dentist | 2929 The Villages Parkway, San Jose, CA 95135 | 2006-08-24 |
| 1821034232 | Anupama Balakrishnan | Family Medicine | 1333 Meridian Avenue, San Jose, CA 95135 | 2006-06-22 |
| 1154485142 | Sharon Diana Hoefling | Dentist | 4205 San Felipe Rd, Suite 200, San Jose, CA 95135 | 2006-12-21 |
| 1679889869 | Binh Bao Lam | Dentist | 3869 Thompson Creek Ct, San Jose, CA 95135-1000 | 2010-08-25 |
| 1780187666 | Edna Porter Lewis | Counselor | 4078 Lawther Ct, San Jose, CA 95135-1021 | 2018-03-16 |
| 1346708310 | Atin Gupta | Physical Therapist | 4205 Ruby Ave, San Jose, CA 95135-1109 | 2019-03-07 |
| 1760708911 | Roberto J Sepulveda | Dentist | 3172 Linkfield Way, San Jose, CA 95135-1116 | 2010-04-13 |
| Find all providers in zip 95135 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558664243 | Sean Cheng | Rehabilitation Practitioner | 1754 Technology Dr Ste 225, San Jose, CA 95110-1319 | 2010-12-17 |
| 1508411307 | Brittany Skinner | Rehabilitation Practitioner | 2160 The Alameda, San Jose, CA 95126-1122 | 2019-08-08 |
| 1194263566 | Lucia Diana Hernandez-ulloa | Rehabilitation Practitioner | 645 Wool Creek Dr, Suite 97, San Jose, CA 95112-2617 | 2017-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
| 1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
| 1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
| 1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
| 1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
| 1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
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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.