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General NPI Number Information
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NPI Number | 1437002672
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Entity Type | Organization
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Legal Business Name | DIVINE FIJIANS HOME CARE
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 3270 MENDOCINO AVE
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City | SANTA ROSA
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State | CA
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Zip | 95403-2263
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Country | US
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Telephone | 916-391-8933
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Fax | 707-800-7679
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Provider Business Mailing Address
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Address Line | 3270 MENDOCINO AVE
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City | SANTA ROSA
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State | CA
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Zip | 95403-2263
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Country | US
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Telephone | 916-391-8933
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Fax | 707-800-7679
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Authorized Official
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Title or Position | CHIEF OPERATION OFFICER
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Name | MR. SANAILA SERU MATAKIBAU
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Credential |
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Telephone | 510-432-1227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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