Provider Demographics
NPI:1003316290
Name:CALIFORNIA CAREGIVERS HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CALIFORNIA CAREGIVERS HOME HEALTHCARE LLC
Other - Org Name:CALIFORNIA CAREGIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-478-2828
Mailing Address - Street 1:1100 CORPORATE WAY # 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-6120
Mailing Address - Country:US
Mailing Address - Phone:916-478-2828
Mailing Address - Fax:
Practice Address - Street 1:1100 CORPORATE WAY # 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-6120
Practice Address - Country:US
Practice Address - Phone:916-478-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344700010253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care