Healthcare Provider Details
I. General information
NPI: 1992463772
Provider Name (Legal Business Name): ASSURANCE CARE NURSING HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31515 RANCHO PUEBLO RD STE 102
TEMECULA CA
92592-4837
US
IV. Provider business mailing address
30724 BENTON RD STE C302
WINCHESTER CA
92596-8470
US
V. Phone/Fax
- Phone: 877-885-4088
- Fax:
- Phone: 601-316-4353
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOLULOPE
TITILAYO
ADEDAYO
Title or Position: DIRECTOR
Credential: DNP, MSN, FNP-C, PMH
Phone: 951-777-0788