Healthcare Provider Details

I. General information

NPI: 1457871287
Provider Name (Legal Business Name): GENERATIONS HEALTHCARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S ROSEMEAD BLVD STE J
PASADENA CA
91107-3954
US

IV. Provider business mailing address

110 S ROSEMEAD BLVD STE J
PASADENA CA
91107-3954
US

V. Phone/Fax

Practice location:
  • Phone: 818-655-0500
  • Fax: 818-655-0501
Mailing address:
  • Phone: 818-655-0500
  • Fax: 818-655-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AILEEN MAY PUNSALAN
Title or Position: CFO/OWNER
Credential:
Phone: 818-655-0500