MEDICARE: SAN JOSE HOME HEALTH

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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1528026614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JOSE HOME HEALTH

Provider Business Mailing Address
First Line	:	102 LAKE GENEVA DR
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-1918
Country	:	US
Telephone Number	:	956-725-0345
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 LAKE GENEVA DR
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-1918
Country	:	US
Telephone Number	:	956-725-0345
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MISS CLAUDIA GABRIELA MUNOZ
Credential	:	B.A.
Telephone Number	:	956-206-0108

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/22/2020

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Directions to “SAN JOSE HOME HEALTH ” Practice Location

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