Healthcare Provider Details

I. General information

NPI: 1679576607
Provider Name (Legal Business Name): EMERALD HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 E. LOS ANGELES AVENUE SUITE 232
SIMI VALLEY CA
93063-5213
US

IV. Provider business mailing address

5775 E LOS ANGELES AVE STE 232
SIMI VALLEY CA
93063-5215
US

V. Phone/Fax

Practice location:
  • Phone: 805-864-9311
  • Fax: 805-864-9312
Mailing address:
  • Phone: 805-864-9311
  • Fax: 805-864-9312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980000651
License Number StateCA

VIII. Authorized Official

Name: MRS. KRYSTIANNE NIGEL ABRENICA KENNEDY
Title or Position: ADMINISTRATOR/PRESIDENT
Credential: MSN, RN-BC
Phone: 805-864-9311