Provider Demographics
NPI:1619911948
Name:RCR STAR MANAGEMENT OF SAN JOSE, INC.
Entity Type:Organization
Organization Name:RCR STAR MANAGEMENT OF SAN JOSE, INC.
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DHCS/CCO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:530-221-1212
Mailing Address - Street 1:2608 VICTOR AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1447
Mailing Address - Country:US
Mailing Address - Phone:530-221-1212
Mailing Address - Fax:530-221-7836
Practice Address - Street 1:1762 TECHNOLOGY DR
Practice Address - Street 2:SUITE 211
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-1378
Practice Address - Country:US
Practice Address - Phone:408-292-5680
Practice Address - Fax:408-292-5685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000144251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA07258FMedicaid
CAHHA07258FMedicaid