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General NPI Number Information
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NPI Number | 1063033595
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Entity Type | Organization
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Legal Business Name | KINKAID PRIVATE NURSING CARE INC.
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 4012 KATELLA AVE STE 104
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3451
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Country | US
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Telephone | 866-337-4596
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Fax | 310-388-5622
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Provider Business Mailing Address
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Address Line | 4012 KATELLA AVE STE 104
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3451
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Country | US
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Telephone | 866-337-4596
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Fax | 310-388-5622
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER BEMBRY
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Credential |
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Telephone | 310-866-9648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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