Provider Demographics
NPI:1245360940
Name:VILLA VITTORIA
Entity type:Organization
Organization Name:VILLA VITTORIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSEE
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MBA
Authorized Official - Phone:925-323-7903
Mailing Address - Street 1:1191 VISTA RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518
Mailing Address - Country:US
Mailing Address - Phone:925-323-7903
Mailing Address - Fax:
Practice Address - Street 1:1191 VISTA RIDGE CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1739
Practice Address - Country:US
Practice Address - Phone:925-323-7903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA075600737310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility