Healthcare Provider Details

I. General information

NPI: 1538074745
Provider Name (Legal Business Name): PEACE OF MIND HOME HEALTHCARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 VISTA VALLEY DR. UNIT J
DIAMOND BAR CA
91709
US

IV. Provider business mailing address

13307 CARDINAL RIDGE RD UNIT J
CHINO HILLS CA
91709-1271
US

V. Phone/Fax

Practice location:
  • Phone: 562-719-5931
  • Fax:
Mailing address:
  • Phone: 562-719-5931
  • Fax:

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: KAMASHA MONIQUE TANNER
Title or Position: GENERAL MANAGER
Credential: LVN,DSD
Phone: 840-272-9317