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General NPI Number Information
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NPI Number | 1447069224
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Entity Type | Organization
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Legal Business Name | MARCELA'S HOME
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1969 N. LILAC AVENUE
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City | RIALTO
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State | CA
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Zip | 92376-2377
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Country | US
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Telephone | 415-713-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 S STATE COLLEGE BLVD APT 2041
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City | ANAHEIM
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State | CA
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Zip | 92806-6218
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Country | US
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Telephone | 415-713-9267
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR OF NURSING
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Name | ASHLEY CARBAJAL
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Credential | REGISTERED NURSE
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Telephone | 415-713-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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