Provider Demographics
NPI:1669024121
Name:KALINGA CARE HOME
Entity type:Organization
Organization Name:KALINGA CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADET
Authorized Official - Middle Name:VIRAY
Authorized Official - Last Name:GUEVARRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP
Authorized Official - Phone:650-576-0836
Mailing Address - Street 1:1230 VANCOUVER WAY
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6028
Mailing Address - Country:US
Mailing Address - Phone:925-453-6128
Mailing Address - Fax:925-453-6109
Practice Address - Street 1:1230 VANCOUVER WAY
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6028
Practice Address - Country:US
Practice Address - Phone:925-453-6128
Practice Address - Fax:925-453-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1669024121Medicaid
CA5550005935OtherCLHF LICENSE