EVANGELINA JACY
NPI 1003365180
Assisted Living Facility in San Jose, CA

Q: What is Evangelina Jacy's NPI number?

The NPI number for Evangelina Jacy is 1003365180. It was assigned to this individual provider in the NPPES registry on September 29, 2016.

Q: What is Evangelina Jacy's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Evangelina Jacy was last updated on September 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 29, 2016

1820 BETHANY AVE, SAN JOSE, CA 95132(408) 250-2568(408) 729-3282 Get Directions Write a Review

NPPES record last updated: September 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Evangelina Jacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVANGELINA JACY (NPI 1003365180) is an individual assisted living facility provider in San Jose, California, licensed in California (435201652) and active in the NPI registry since September 2016.

NPPES Registry Identity

NPI1003365180

Entity TypeIndividualFemale

Primary Taxonomy310400000X

Provider Legal NameEVANGELINA JACY

Location Address1820 BETHANY AVESan Jose, CA 95132-1514

Mailing Address1824 Bethany AveSan Jose, CA 95132-1514 · (408) 250-2568 · Fax (408) 729-3282

Phone(408) 250-2568

Fax(408) 729-3282

Sole ProprietorYes

Enumeration DateSeptember 29, 2016

✔ NPI 1003365180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in CA · 435201652

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1820 BETHANY AVE, San Jose, CA 95132

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LILIAN CANLAS SACUN

Nursing Home Administrator

1820 BETHANY AVE
SAN JOSE, CA 95132

Santa Clara County (408) 649-6532

ROSE GUEST HOME

Assisted Living Facility

1820 BETHANY AVE
SAN JOSE, CA 95132

Santa Clara County (650) 892-3936

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evangelina Jacy's NPI number?

The NPI number for Evangelina Jacy is 1003365180. It was assigned to this individual provider in the NPPES registry on September 29, 2016.

Where is Evangelina Jacy located?

Evangelina Jacy practices at 1820 Bethany Ave, San Jose, CA 95132. The listed phone number is (408) 250-2568.

What is Evangelina Jacy's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Evangelina Jacy was last updated on September 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.