Healthcare Provider Details

I. General information

NPI: 1902803752
Provider Name (Legal Business Name): JOBET CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 WILLIAMS ST STE 310
SIMI VALLEY CA
93065-7842
US

IV. Provider business mailing address

1919 WILLIAMS ST STE 310
SIMI VALLEY CA
93065-7842
US

V. Phone/Fax

Practice location:
  • Phone: 818-548-2684
  • Fax: 818-548-7384
Mailing address:
  • Phone: 818-548-2684
  • Fax: 818-548-7384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number980001394
License Number StateCA

VIII. Authorized Official

Name: IVAN LAURITZEN
Title or Position: ADMINISTRATOR
Credential: NHA 7607
Phone: 818-548-2684