Healthcare Provider Details

I. General information

NPI: 1992320329
Provider Name (Legal Business Name): TELECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 RAMONA EXPY
PERRIS CA
92571-7014
US

IV. Provider business mailing address

85 RAMONA EXPY STE 1
PERRIS CA
92571-7014
US

V. Phone/Fax

Practice location:
  • Phone: 951-349-4195
  • Fax:
Mailing address:
  • Phone: 951-349-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PARKS
Title or Position: CEO
Credential:
Phone: 951-312-5187