Healthcare Provider Details

I. General information

NPI: 1548050719
Provider Name (Legal Business Name): YEMAYA HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 MADERA RD. # 19
SIMI VALLEY CA
93065-4019
US

IV. Provider business mailing address

1302 MADERA RD. # 19
SIMI VALLEY CA
93065-4019
US

V. Phone/Fax

Practice location:
  • Phone: 310-967-9076
  • Fax: 213-468-8342
Mailing address:
  • Phone: 310-967-9076
  • Fax: 213-468-8342

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: JESSICA RAMIREZ
Title or Position: OWNER
Credential:
Phone: 310-967-9076