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General NPI Number Information
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NPI Number | 1336178292
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Entity Type | Organization
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Legal Business Name | STOVALL WILSON HOME CARE
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 190 SIERRA CT STE. B 217
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City | PALMDALE
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State | CA
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Zip | 93550-7607
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Country | US
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Telephone | 661-273-3755
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Fax | 661-273-3755
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Provider Business Mailing Address
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Address Line | 190 SIERRA CT STE. B 217
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City | PALMDALE
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State | CA
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Zip | 93550-7607
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Country | US
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Telephone | 661-273-3755
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Fax | 661-273-3755
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SANDRA DENNIESE STOVALL WILSON
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Credential | LVN
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Telephone | 661-273-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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Taxonomy #3
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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Taxonomy #4
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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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