Healthcare Provider Details

I. General information

NPI: 1154236289
Provider Name (Legal Business Name): EARLY HORIZON HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 SHANNON DR
SOUTH SAN FRANCISCO CA
94080-5320
US

IV. Provider business mailing address

2800 SHANNON DR
SOUTH SAN FRANCISCO CA
94080-5320
US

V. Phone/Fax

Practice location:
  • Phone: 650-438-6710
  • Fax:
Mailing address:
  • Phone: 650-438-6710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: IRENE MEHTA
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 650-438-6710