MEDICARE: ACCENTCARE HOME HEALTH OF CALIFORNIA, 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	020000285	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ61327Z	OTHER		BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972559961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCENTCARE HOME HEALTH OF CALIFORNIA, INC.

Provider Business Mailing Address
First Line	:	17855 DALLAS PKWY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75287-6852
Country	:	US
Telephone Number	:	972-267-1100
Fax Number	:	972-267-1116

Provider Business Practice Location Address
First Line	:	3170 CROW CANYON PL STE 270
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1157
Country	:	US
Telephone Number	:	800-734-1604
Fax Number	:	925-659-0009

Authorized Official
Title or Position	:	VP LEGAL
Name	:	M'LISS JONES KANE
Credential	:
Telephone Number	:	949-623-1582

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/03/2019

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