Healthcare Provider Details

I. General information

NPI: 1164746038
Provider Name (Legal Business Name): AVERY HOME HEALTH AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 THE CITY DR S STE 480
ORANGE CA
92868-4940
US

IV. Provider business mailing address

750 THE CITY DR S STE 480
ORANGE CA
92868-4940
US

V. Phone/Fax

Practice location:
  • Phone: 714-798-2537
  • Fax: 714-902-6996
Mailing address:
  • Phone: 714-798-2537
  • Fax: 714-902-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE BAILEY
Title or Position: DIRECTOR OF SPECIAL PROJECTS
Credential:
Phone: 661-373-5943