Healthcare Provider Details

I. General information

NPI: 1346162484
Provider Name (Legal Business Name): PACIFIC ANGELS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9053 SOQUEL DR STE B
APTOS CA
95003-4034
US

IV. Provider business mailing address

9053 SOQUEL DR STE B
APTOS CA
95003-4034
US

V. Phone/Fax

Practice location:
  • Phone: 831-708-2876
  • Fax: 831-708-2784
Mailing address:
  • Phone: 831-708-2876
  • Fax: 831-708-2784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA MCCUE
Title or Position: CARE COORDINATOR
Credential:
Phone: 831-708-2876