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General NPI Number Information
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NPI Number | 1053876300
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Entity Type | Organization
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Legal Business Name | ST. JULIANA HOMECARE, LLC
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 2410 CAMINO RAMON STE 166
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City | SAN RAMON
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State | CA
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Zip | 94583-4323
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Country | US
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Telephone | 513-404-6344
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Fax |
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Provider Business Mailing Address
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Address Line | 5626 OWENS DR APT 102
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City | PLEASANTON
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State | CA
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Zip | 94588-4672
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Country | US
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Telephone | 513-404-6344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GENIE-LORRAINE MARIE HOFFMAN-STIRRAT
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Credential |
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Telephone | 513-404-6344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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