=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083584627
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INFINITY HOME HEALTH/ HOSPICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2025
-----------------------------------------------------
Last Update Date | 11/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1325 N CENTER ST
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95202-1020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-264-0300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1325 N CENTER ST
-----------------------------------------------------
City | STOCKTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95202-1020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HOSPICE NP
-----------------------------------------------------
Name | JOHANA ANKOMAHENE
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 209-894-9491
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------