Provider Demographics
NPI:1316088099
Name:TRI-VALLEY HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:TRI-VALLEY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NECITA
Authorized Official - Middle Name:TECSON
Authorized Official - Last Name:TRIGUERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-957-0708
Mailing Address - Street 1:37 W YOKUTS AVE STE C2
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5725
Mailing Address - Country:US
Mailing Address - Phone:209-957-0708
Mailing Address - Fax:209-957-7866
Practice Address - Street 1:37 W YOKUTS AVE STE C2
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5725
Practice Address - Country:US
Practice Address - Phone:209-957-0708
Practice Address - Fax:209-957-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000689251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health