MEDICARE: K.K.A. HOME HEALTH CARE INC

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	:	1952892861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K.K.A. HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	8925 SEPULVEDA BLVD STE 213
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4354
Country	:	US
Telephone Number	:	818-655-0305
Fax Number	:	818-334-8767

Provider Business Practice Location Address
First Line	:	8925 SEPULVEDA BLVD STE 213
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4354
Country	:	US
Telephone Number	:	818-655-0305
Fax Number	:	818-334-8767

Authorized Official
Title or Position	:	CEO
Name	:	ERIK HARUTYUNYAN
Credential	:
Telephone Number	:	818-655-0305

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	03/12/2026

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