Healthcare Provider Details
I. General information
NPI: 1366244782
Provider Name (Legal Business Name): MD'S HOMECARE PROFESSIONALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1280 COYOTE CREEK PL
SAN JOSE CA
95116-1083
US
IV. Provider business mailing address
1280 COYOTE CREEK PL
SAN JOSE CA
95116-1083
US
V. Phone/Fax
- Phone: 408-621-3128
- Fax:
- Phone: 408-621-3128
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARISSA
P
DAYRIT
Title or Position: SECRETARY
Credential: N/A
Phone: 408-621-3128