Healthcare Provider Details

I. General information

NPI: 1780329771
Provider Name (Legal Business Name): EZ CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 CORPORATE WAY
SACRAMENTO CA
95831-3875
US

IV. Provider business mailing address

1104 CORPORATE WAY
SACRAMENTO CA
95831-3875
US

V. Phone/Fax

Practice location:
  • Phone: 844-397-4337
  • Fax:
Mailing address:
  • Phone: 844-397-4337
  • Fax:

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 Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: KHAULA NIXON
Title or Position: MANAGING MEMBER
Credential:
Phone: 916-395-4453