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General NPI Number Information
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NPI Number | 1225949043
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Entity Type | Organization
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Legal Business Name | JUBILEE TIME HEALTH CARE SERVICES
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 14023 CRENSHAW BLVD STE 10
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City | HAWTHORNE
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State | CA
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Zip | 90250-9255
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Country | US
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Telephone | 562-396-1831
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Fax | 310-758-5730
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Provider Business Mailing Address
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Address Line | 14023 CRENSHAW BLVD STE 10
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City | HAWTHORNE
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State | CA
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Zip | 90250-9255
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Country | US
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Telephone | 562-396-1831
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Fax | 310-758-5730
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Authorized Official
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Title or Position | DNP/ DIRECTOR
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Name | VIVIENNE AGHOGHO AYOMANOR
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Credential | PMHNP-BC, FNP-C
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Telephone | 562-396-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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