=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386443513
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 2ND HOME ADULT HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 02/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3225 FLETCHER DR
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90065-2919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-292-1212
-----------------------------------------------------
Fax | 858-952-0509
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17220 SUNBURST ST
-----------------------------------------------------
City | SHERWOOD FOREST
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325-2923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-292-1212
-----------------------------------------------------
Fax | 858-952-0509
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SOFIA DJAVADIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-926-0536
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------