MEDICARE: AVISTA HOME CARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1932055043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVISTA HOME CARE

Provider Business Mailing Address
First Line	:	720 S. RAMONA AVE SUITE 202
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879
Country	:	US
Telephone Number	:	951-577-4360
Fax Number	:	951-356-1782

Provider Business Practice Location Address
First Line	:	720 S. RAMONA AVE SUITE 202
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879
Country	:	US
Telephone Number	:	951-577-4360
Fax Number	:	951-356-1782

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. GODFREY UZOCHUKWU NWOGENE
Credential	:
Telephone Number	:	951-577-4360

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “AVISTA HOME CARE ” Practice Location

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