Provider Demographics
NPI:1366081614
Name:NORTHERN CALIFORNIA HOME HEALTH SERVICES
Entity type:Organization
Organization Name:NORTHERN CALIFORNIA HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:PABLO
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-205-0215
Mailing Address - Street 1:3441 DATA DR APT 368
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7996
Mailing Address - Country:US
Mailing Address - Phone:915-205-0215
Mailing Address - Fax:
Practice Address - Street 1:3441 DATA DR APT 368
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-7996
Practice Address - Country:US
Practice Address - Phone:915-205-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health