Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Evergreen at Petaluma, LLC

Organization Skilled Nursing Facility · NPI 1104874940

Evergreen at Petaluma, LLC is a Skilled Nursing Facility in Petaluma, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Douglas St
Petaluma, CA 94952-2503
Phone: (707) 763-6887
Fax: (707) 763-0314
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 010000018 (CA)

Record details

NPI number1104874940
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEmpres California Healthcare, LLC
Authorized official Brent Weil — Ceo And Manager · (360) 892-6628
Other names Empres Post Acute Rehabilitation
NPI enumeratedMay 4, 2006
Last updated in NPPESJanuary 30, 2017
Mailing address4601 Ne 77th Ave, Suite 300, Vancouver, WA 98662-6729

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