Healthcare Provider Details

I. General information

NPI: 1669655486
Provider Name (Legal Business Name): JC HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2007
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 KUEHNER DR SUITE 112
SIMI VALLEY CA
93063-3900
US

IV. Provider business mailing address

2315 KUEHNER DR SUITE 112
SIMI VALLEY CA
93063-3900
US

V. Phone/Fax

Practice location:
  • Phone: 805-390-7165
  • Fax: 805-823-6219
Mailing address:
  • Phone: 805-527-3527
  • Fax: 805-527-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number550001032
License Number StateCA

VIII. Authorized Official

Name: ANNIE TRAM DARBY
Title or Position: CEO
Credential:
Phone: 805-390-7428