Healthcare Provider Details

I. General information

NPI: 1073409959
Provider Name (Legal Business Name): MOTHER MINDS PERSONAL HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 JACKSON ST SPC 11
NORTH HIGHLANDS CA
95660-5341
US

IV. Provider business mailing address

5040 JACKSON ST SPC 11
NORTH HIGHLANDS CA
95660-5341
US

V. Phone/Fax

Practice location:
  • Phone: 916-699-9184
  • Fax:
Mailing address:
  • Phone: 916-699-9184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA MARIE RAM
Title or Position: CEO
Credential: HEALTH CARE
Phone: 916-699-9184