EMERALD KEY VILLA INC


Address: 15860 Siesta Vista Drive, San Jose, CA 95127
Phone: 4083908533

EMERALD KEY VILLA INC (NPI# 1932404555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932404555
Entity Type Organization
Organization Name EMERALD KEY VILLA INC
Practice Address 15860 Siesta Vista Drive
San Jose
CA 95127
Mailing Address Po Box 32804
San Jose
CA 95152
Practice Telephone 4083908533
Mailing Telephone 4083908533
Enumeration Date 2011-01-12
Last Update Date 2011-01-12
Authorized Official Name ANGELINA QUEDADO DOOLABH (CORPORATE OFFICER)
Authorized Official Telephone 4083908533
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded Nursing & Custodial Care Facilities

Office Location

Street Address 15860 SIESTA VISTA DRIVE
City SAN JOSE
State CA
Zip Code 95127

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1407359383 Erin Rodriguez Behavior Technician 1593 Amesbury Way, San Jose, CA 95127 2018-03-16
1407209919 Binita Dorce Counselor 14820 Mcvay Avenue, San Jose, CA 95127 2016-07-20
1851766448 Lynn H Trieu Pharmacist 3200 Kawalker Ln, San Jose, CA 95127 2015-12-08
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1710363916 Chan Pham Acupuncturist 10048 Bethel Ave, San Jose, CA 95127 2015-08-11
1639574320 Jesus I Yanez Dentist 100 South White Road Suite 210, San Jose, CA 95127 2014-10-24
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Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518390483 Almond Home II Inc Intermediate Care Facility, Mentally Retarded 2551 Gumdrop Dr, San Jose, CA 95148-2019 2013-08-15
1053659086 Mcr Care Inc. Intermediate Care Facility, Mentally Retarded 2223 Golden Dew Cir, San Jose, CA 95121-1441 2013-01-25
1396995072 Circle of Care Corporation Intermediate Care Facility, Mentally Retarded 2130 Turnhouse Lane, San Jose, CA 95121-1377 2008-09-30
1912163031 Tupaz Home # 14 Intermediate Care Facility, Mentally Retarded 14716 Union Ave, San Jose, CA 95124-3574 2008-07-29
1790949303 Silver Punzalan II Inc Intermediate Care Facility, Mentally Retarded 2928 Silver Est, San Jose, CA 95135-1234 2008-07-12
1205019767 Mouri Management Group Incorporated Intermediate Care Facility, Mentally Retarded 2492 Aram Ave, San Jose, CA 95128-4209 2007-12-07
1922219476 Tupaz Home # 3 Intermediate Care Facility, Mentally Retarded 1955 Patio Dr, San Jose, CA 95125-5652 2007-05-25
1518178904 Tupaz Home # 10 Intermediate Care Facility, Mentally Retarded 2893 Ross Ave, San Jose, CA 95124-1848 2007-05-25
1841401213 Tupaz Home # 7 Intermediate Care Facility, Mentally Retarded 308 Marti Way, San Jose, CA 95136-2135 2007-05-25
1922219302 Tupaz Home # 8 Intermediate Care Facility, Mentally Retarded 4189 Leigh Ave, San Jose, CA 95124-3612 2007-05-25
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City SAN JOSE
Zip Code 95127

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Dataset Information

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.

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