Provider Demographics
NPI:1285795559
Name:THE HOSPITAL COMMITTEE FOR THE LIVERMORE-PLEASANTON AREAS
Entity type:Organization
Organization Name:THE HOSPITAL COMMITTEE FOR THE LIVERMORE-PLEASANTON AREAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-373-8023
Mailing Address - Street 1:PO BOX 4656
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94540-4656
Mailing Address - Country:US
Mailing Address - Phone:925-373-8023
Mailing Address - Fax:925-373-8025
Practice Address - Street 1:1111 E STANLEY BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4115
Practice Address - Country:US
Practice Address - Phone:925-373-8023
Practice Address - Fax:925-373-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555335Medicare Oscar/Certification