Healthcare Provider Details

I. General information

NPI: 1477762276
Provider Name (Legal Business Name): VISITING NURSE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 MOTT ST STE 150
SAN FERNANDO CA
91340-4241
US

IV. Provider business mailing address

732 MOTT ST STE 150
SAN FERNANDO CA
91340-4241
US

V. Phone/Fax

Practice location:
  • Phone: 818-837-3775
  • Fax: 818-837-3799
Mailing address:
  • Phone: 818-837-3775
  • Fax: 818-837-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000601
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: WILMA JUNE SIMMONS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 818-837-3775