=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376465435
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JC HARMONY CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2026
-----------------------------------------------------
Last Update Date | 07/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 670 CRENSHAW BLVD # 101
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90005-3622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-210-0365
-----------------------------------------------------
Fax | 562-202-5009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2300 S PACIFIC AVE # 101
-----------------------------------------------------
City | SAN PEDRO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90731-5936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-210-0365
-----------------------------------------------------
Fax | 562-202-5009
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PATRIA MARAVILLA DUFRENNE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 909-210-0365
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------