Healthcare Provider Details
I. General information
NPI: 1982602496
Provider Name (Legal Business Name): LOS ROBLES HOMECARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2005
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 MARIN ST STE 135
THOUSAND OAKS CA
91360-7897
US
IV. Provider business mailing address
1881 W TRAVERSE PKWY STE E112
LEHI UT
84048-6029
US
V. Phone/Fax
- Phone: 805-777-7234
- Fax: 805-777-0101
- Phone: 805-777-7234
- Fax: 805-777-0101
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 050000552 |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
STEVEN
BURNINGHAM
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 415-845-3213