FRUITVALE HEALTH CARE CENTER
NPI 1508295478
Skilled Nursing Facility in Oakland, CA

NPI Status: Active since November 01, 2013

Contact Information

3020 E 15TH ST
OAKLAND, CA
ZIP 94601
Phone: (510) 261-5613

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 05D0883158
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 02-25-2026

About FRUITVALE HEALTH CARE CENTER

This page provides the complete NPI Profile along with additional information for Fruitvale Health Care Center, a provider established in Oakland, California operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1508295478 assigned on November 2013. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Fruitvale Health Care Center. The authorized official of this NPI record is Kam Mcgavock (President)

NPI
1508295478
Provider Legal Name
FRUITVALE LONG TERM CARE LLC
Other Organization Name
FRUITVALE HEALTH CARE CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3020 E 15TH ST OAKLAND, CA 94601
Location Phone
(510) 261-5613
Mailing Address
920 RIDGEBROOK RD SPARKS, MD 21152
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-01-2013
Last Update Date
11-01-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KAM MCGAVOCK

Authorized Official Title
PRESIDENT
Authorized Official Phone
(410) 773-1000

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D0883158
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
February 26, 2024
Certificate Expiration Date
February 25, 2026
Laboratory Director
TYRONE SNIPES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Fruitvale Health Care Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1508295478, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
0
Doubled → 0
Pos 4
8
Unchanged
Pos 5
2
Doubled → 4
Pos 6
9
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 2 → 4 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 0 + 8 + 4 + 9 + 1 + 0 + 4 + 1 + 4 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1508295478.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Physical Therapist
3020 E 15TH ST
OAKLAND, CA 94601
Skilled Nursing Facility
3020 E 15TH ST
OAKLAND, CA 94601
Speech-Language Pathologist
3020 E 15TH ST
OAKLAND, CA 94601
Occupational Therapist
3020 E 15TH ST
OAKLAND, CA 94601
Skilled Nursing Facility
3020 E 15TH ST
OAKLAND, CA 94601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508295478, enumerated as an "organization" on November 01, 2013.

The provider is located at 3020 E 15TH ST OAKLAND, CA 94601 and the phone number is (510) 261-5613.

Skilled Nursing Facility with taxonomy code 314000000X.