Healthcare Provider Details

I. General information

NPI: 1013967314
Provider Name (Legal Business Name): JSI ACQUISITION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 SEPULVEDA BLVD SUITE 605
SHERMAN OAKS CA
91411-2546
US

IV. Provider business mailing address

5805 SEPULVEDA BLVD SUITE 605
SHERMAN OAKS CA
91411-2546
US

V. Phone/Fax

Practice location:
  • Phone: 818-902-5000
  • Fax: 818-902-5008
Mailing address:
  • Phone: 818-902-5000
  • Fax: 818-902-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980000470
License Number StateCA

VIII. Authorized Official

Name: MR. JONATHAN ISTRIN
Title or Position: PRESIDENT
Credential:
Phone: 818-902-5000