Healthcare Provider Details

I. General information

NPI: 1821912023
Provider Name (Legal Business Name): OAK & VALE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13943 TRIGGER LN
VICTORVILLE CA
92392-6333
US

IV. Provider business mailing address

13943 TRIGGER LN
VICTORVILLE CA
92392-6333
US

V. Phone/Fax

Practice location:
  • Phone: 760-266-7772
  • Fax: 760-266-7774
Mailing address:
  • Phone: 760-266-7772
  • Fax: 760-266-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: METAKSYA DIREMSIZIAN METAKSYA DIREMSIZIAN
Title or Position: CEO
Credential:
Phone: 760-266-7772