Healthcare Provider Details

I. General information

NPI: 1548174113
Provider Name (Legal Business Name): OTUMAPA SENIOR HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46704 RANCHO HIGUERA RD
FREMONT CA
94539-6982
US

IV. Provider business mailing address

46704 RANCHO HIGUERA RD
FREMONT CA
94539-6982
US

V. Phone/Fax

Practice location:
  • Phone: 650-458-1698
  • Fax:
Mailing address:
  • Phone: 650-458-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: FATAI UNGA
Title or Position: OWNER
Credential:
Phone: 650-458-1698