Healthcare Provider Details

I. General information

NPI: 1578242673
Provider Name (Legal Business Name): TRINITY JOMAIRA ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 HANSBERRY CT NE
WASHINGTON DC
20018-3841
US

IV. Provider business mailing address

3717 HANSBERRY CT NE
WASHINGTON DC
20018-3841
US

V. Phone/Fax

Practice location:
  • Phone: 202-696-5682
  • Fax:
Mailing address:
  • Phone: 202-696-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code226000000X
TaxonomyRecreational Therapist Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: