Petalumaidence Opco, LLC
NPI 1356883805ActiveOrganization· Skilled Nursing Facility· Petaluma, CA
Skilled Nursing Facility in Petaluma, California, registered in NPPES in November 2016. The authorized official on file is John Mitchell, Secretary. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1356883805 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 15, 2016 |
| Last updated in NPPES | Aug 20, 2024 |
| Certified by provider | Aug 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (CA) |
|---|
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