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General NPI Number Information
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NPI Number | 1528946852
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Entity Type | Individual
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Provider Name | JAYLAH SIRCA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 30707 LAKE SHORE BLVD
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City | WILLOWICK
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State | OH
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Zip | 44095-3671
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Country | US
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Telephone | 303-345-1526
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 WASHINGTON AVE APT 6
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City | GOLDEN
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State | CO
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Zip | 80401-1153
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Country | US
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Telephone | 303-345-1526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | OH
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