Provider Demographics
NPI:1679448955
Name:CHENIN BLANC ASSISTED LIVING
Entity type:Organization
Organization Name:CHENIN BLANC ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKIYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-213-9128
Mailing Address - Street 1:5326 CHENIN BLANC PL
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8387
Mailing Address - Country:US
Mailing Address - Phone:707-645-8168
Mailing Address - Fax:
Practice Address - Street 1:5326 CHENIN BLANC PL
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8387
Practice Address - Country:US
Practice Address - Phone:707-645-8168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty