MEDICARE: URR EPIPHANY

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1952096687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URR EPIPHANY

Provider Business Mailing Address
First Line	:	2127 W 78TH PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-2605
Country	:	US
Telephone Number	:	805-279-1907
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 W 99TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90003-4114
Country	:	US
Telephone Number	:	805-279-1907
Fax Number	:

Authorized Official
Title or Position	:	OWNER/FOUNDER
Name	:	MS. SUNSET OLINEY
Credential	:
Telephone Number	:	805-279-1907

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	04/10/2023

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Directions to “URR EPIPHANY ” Practice Location

Language	Start Address	Practice Location

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