Provider Demographics
NPI:1285095299
Name:ANX HOME HEALTHCARE NURSING - SANTA CLARA INC.
Entity type:Organization
Organization Name:ANX HOME HEALTHCARE NURSING - SANTA CLARA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS ALLANDALE
Authorized Official - Middle Name:LAGROSAS
Authorized Official - Last Name:ROCAS
Authorized Official - Suffix:III
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:650-271-5721
Mailing Address - Street 1:828 S BASCOM AVE
Mailing Address - Street 2:STE 240
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2651
Mailing Address - Country:US
Mailing Address - Phone:650-271-5721
Mailing Address - Fax:650-991-5178
Practice Address - Street 1:455 HICKEY BLVD STE 415
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2630
Practice Address - Country:US
Practice Address - Phone:650-271-5721
Practice Address - Fax:650-991-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health