MEDICARE: NORCAL ELITE CARE HOME HEALTH SERVICES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1942906821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORCAL ELITE CARE HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	8412 BROOKLYN RD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-9561
Country	:	US
Telephone Number	:	916-753-4133
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 FITE CIR STE 208B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-1807
Country	:	US
Telephone Number	:	916-753-4133
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATIVE
Name	:	JUDY AQUINO
Credential	:
Telephone Number	:	916-753-4133

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	02/03/2023

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