Healthcare Provider Details

I. General information

NPI: 1083498208
Provider Name (Legal Business Name): JEMA HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 SCOTT AVE
CLOVIS CA
93619-5309
US

IV. Provider business mailing address

4121 SCOTT AVE
CLOVIS CA
93619-5309
US

V. Phone/Fax

Practice location:
  • Phone: 831-208-4416
  • Fax: 559-593-7635
Mailing address:
  • Phone: 831-208-4416
  • Fax: 559-593-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. OGHOGHO UHUNMWANGHO
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 831-208-4416