WELLBOUND OF MENLO PARK LLC NPI 1144292186

NPI Information

NPI: 1144292186
Provider Name: WELLBOUND OF MENLO PARK LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: SATELLITE WELLBOUND OF FREMONT
CLIA Number: 05D1015752
Address: 39510 PASEO PADRE PKWY
SUITE 100
FREMONT, CA
ZIP 94538
Phone: (510) 953-7800

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NPI Details

WELLBOUND OF MENLO PARK LLC is an end-stage renal disease (esrd) treatment clinic center in Fremont, CA. WELLBOUND OF MENLO PARK LLC NPI is 1144292186. The provider is registered as an organization entity type.
The provider Is Doing Business As Satellite Wellbound Of Fremont.

The provider's business location address is:

39510 PASEO PADRE PKWY
SUITE 100
FREMONT, CA
ZIP 94538-707
Phone: (510) 953-7800
Fax: (510) 739-3810

The provider's authorized official is Bernadette Vincent .
The authorized official title is President/coo and has the following contact phone number (650) 404-3600.

The CLIA number assigned to this NPI record is 05D1015752 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/3/2006 and was last updated on 4/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CDC52514F	MEDICAID	CALIFORNIA
2	05D1015752	OTHER	CALIFORNIA	CMS CLIA CERTIFICATE OF WAIVER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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