Provider Demographics
NPI:1730943838
Name:GINES, ERLINDA
Entity type:Individual
Prefix:
First Name:ERLINDA
Middle Name:
Last Name:GINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 BLUE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4524
Mailing Address - Country:US
Mailing Address - Phone:925-683-2021
Mailing Address - Fax:
Practice Address - Street 1:2565 STONE VALLEY RD
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-2778
Practice Address - Country:US
Practice Address - Phone:925-743-1146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA076501041311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home