Healthcare Provider Details

I. General information

NPI: 1992696892
Provider Name (Legal Business Name): CARING COMPANIONS HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 EASTLAKE CIR
TRACY CA
95304-5806
US

IV. Provider business mailing address

1570 EASTLAKE CIR
TRACY CA
95304-5806
US

V. Phone/Fax

Practice location:
  • Phone: 916-200-6818
  • Fax:
Mailing address:
  • Phone: 916-200-6818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KODOU NJIE-MBOOB
Title or Position: OWNER/MANAGER
Credential:
Phone: 916-200-6818