Healthcare Provider Details

I. General information

NPI: 1770448045
Provider Name (Legal Business Name): CAPITOLA HOME CARE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1836 17TH AVE STE C
SANTA CRUZ CA
95062-1893
US

IV. Provider business mailing address

826 BAY AVE UNIT 243
CAPITOLA CA
95010-4508
US

V. Phone/Fax

Practice location:
  • Phone: 831-227-3983
  • Fax:
Mailing address:
  • Phone: 831-227-3983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA RUIZ
Title or Position: OWNER
Credential:
Phone: 831-227-3983