Healthcare Provider Details

I. General information

NPI: 1568303600
Provider Name (Legal Business Name): MS. ANASTASIIA KHYLKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 VESPER AVE STE 200
VAN NUYS CA
91405-4612
US

IV. Provider business mailing address

6740 VESPER AVE STE 200
VAN NUYS CA
91405-4612
US

V. Phone/Fax

Practice location:
  • Phone: 313-415-5040
  • Fax: 888-645-7007
Mailing address:
  • Phone: 313-415-5040
  • Fax: 888-645-7007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1174174114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: