MEDICARE: JEREMIAH EZEKIEL TRIATIAN POWERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1174452957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMIAH EZEKIEL TRIATIAN POWERS

Provider Business Mailing Address
First Line	:	829 N GARFIELD AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-4224
Country	:	US
Telephone Number	:	706-853-1097
Fax Number	:

Provider Business Practice Location Address
First Line	:	829 N GARFIELD AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-4224
Country	:	US
Telephone Number	:	706-853-1097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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