MEDICARE: A REASON TO SMILE HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1295458172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A REASON TO SMILE HOME CARE

Provider Business Mailing Address
First Line	:	1990 N CALIFORNIA BLVD STE 20-1175
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-3742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 N CALIFORNIA BLVD STE 20-1175
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94596-3742
Country	:	US
Telephone Number	:	707-209-6238
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAIISHA TYLER
Credential	:
Telephone Number	:	707-209-6238

Provider Enumeration Date	:	09/26/2022
Last Update Date	:	09/26/2022

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1841509171 — KEVIN MICHAEL SILAS KING PA-C
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Directions to “A REASON TO SMILE HOME CARE ” Practice Location

Language	Start Address	Practice Location

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