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

Evangelina Jacy

Individual provider Assisted Living Facility · NPI 1003365180

Evangelina Jacy is an Assisted Living Facility in San Jose, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016

Practice location Address checks out

1820 Bethany Ave
San Jose, CA 95132-1514
Phone: (408) 250-2568
Fax: (408) 729-3282
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 435201652 (CA)

Record details

NPI number1003365180
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 29, 2016
Last updated in NPPESSeptember 29, 2016
Mailing address1824 Bethany Ave, San Jose, CA 95132-1514

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