Provider Demographics
NPI:1205946555
Name:EAST BAY INTEGRATED CARE, INC
Entity type:Organization
Organization Name:EAST BAY INTEGRATED CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILJESTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-887-5678
Mailing Address - Street 1:3470 BUSKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4316
Mailing Address - Country:US
Mailing Address - Phone:925-887-5678
Mailing Address - Fax:925-887-5672
Practice Address - Street 1:3470 BUSKIRK AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4316
Practice Address - Country:US
Practice Address - Phone:925-887-5678
Practice Address - Fax:925-887-5672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57262FMedicaid
CAHPC01547FMedicaid
CA051547Medicare ID - Type UnspecifiedHOSPICE
CA557262Medicare ID - Type UnspecifiedHOME HEALTH