Healthcare Provider Details

I. General information

NPI: 1841291002
Provider Name (Legal Business Name): VISTA HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 E PALMDALE BLVD STE 4
PALMDALE CA
93550-7138
US

IV. Provider business mailing address

343 E PALMDALE BLVD STE 4
PALMDALE CA
93550-7138
US

V. Phone/Fax

Practice location:
  • Phone: 661-267-0097
  • Fax: 661-267-0096
Mailing address:
  • Phone: 661-267-0097
  • Fax: 661-267-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980000877
License Number StateCA

VIII. Authorized Official

Name: ALMA JASTIA FERNANDEZ
Title or Position: PRESIDENT & CEO
Credential: RN
Phone: 661-267-0097