=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770448045
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPITOLA HOME CARE LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2025
-----------------------------------------------------
Last Update Date | 12/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1836 17TH AVE STE C
-----------------------------------------------------
City | SANTA CRUZ
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95062-1893
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-227-3983
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 826 BAY AVE UNIT 243
-----------------------------------------------------
City | CAPITOLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95010-4508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-227-3983
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LAURA RUIZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 831-227-3983
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------