Provider Demographics
NPI:1083609853
Name:PRIORITY ONE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PRIORITY ONE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPCS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA CHONA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CATUIRA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:909-625-6377
Mailing Address - Street 1:4959 PALO VERDE ST
Mailing Address - Street 2:SUITE 108-C
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2331
Mailing Address - Country:US
Mailing Address - Phone:909-625-6377
Mailing Address - Fax:909-625-6077
Practice Address - Street 1:4959 PALO VERDE ST
Practice Address - Street 2:SUITE 108-C
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763
Practice Address - Country:US
Practice Address - Phone:909-625-6377
Practice Address - Fax:909-625-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000768251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA08063FMedicaid
CA058063Medicare ID - Type Unspecified