Provider Demographics
NPI:1063033595
Name:KINKAID PRIVATE NURSING CARE INC.
Entity Type:Organization
Organization Name:KINKAID PRIVATE NURSING CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEMBRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-866-9648
Mailing Address - Street 1:4012 KATELLA AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3451
Mailing Address - Country:US
Mailing Address - Phone:866-337-4596
Mailing Address - Fax:310-388-5622
Practice Address - Street 1:4012 KATELLA AVE STE 104
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3451
Practice Address - Country:US
Practice Address - Phone:866-337-4596
Practice Address - Fax:310-388-5622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care