Healthcare Provider Details

I. General information

NPI: 1013841097
Provider Name (Legal Business Name): OPO HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 S EL CAMINO REAL STE 407
SAN MATEO CA
94402-3071
US

IV. Provider business mailing address

1528 S EL CAMINO REAL STE 407
SAN MATEO CA
94402-3071
US

V. Phone/Fax

Practice location:
  • Phone: 650-288-3504
  • Fax: 650-288-3505
Mailing address:
  • Phone: 650-288-3504
  • Fax: 650-288-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PRINCE VILLANUEVA
Title or Position: CEO
Credential:
Phone: 650-288-3504