Healthcare Provider Details

I. General information

NPI: 1609497395
Provider Name (Legal Business Name): JMJ HOSPICE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 07/14/2022
Certification Date: 07/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 BRENTWOOD BLVD STE D1
BRENTWOOD CA
94513-5687
US

IV. Provider business mailing address

8640 BRENTWOOD BLVD STE D1
BRENTWOOD CA
94513-5687
US

V. Phone/Fax

Practice location:
  • Phone: 925-390-9575
  • Fax: 925-392-8539
Mailing address:
  • Phone: 925-390-9575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRES JR JAGARAP MELANIO-MARQUINA
Title or Position: ADMINISTRATOR
Credential: BSN, RN
Phone: 925-392-8536