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General NPI Number Information
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NPI Number | 1396103354
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 3187 RED HILL AVE STE 200
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 714-975-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 3187 RED HILL AVE. STE 200
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City | COSTA MESA
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State | CA
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Zip | 92626
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Country | US
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Telephone | 149-758-0117
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Fax |
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Authorized Official
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Title or Position | SERVICE AREA CFO
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Name | LYDIA THANGAIYAN
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Credential |
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Telephone | 714-712-7130
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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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