Provider Demographics
NPI:1790113421
Name:MEDICALONE HEALTH
Entity Type:Organization
Organization Name:MEDICALONE HEALTH
Other - Org Name:MEDICALONE HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISITRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKOCHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-436-3155
Mailing Address - Street 1:3240 LONE TREE WAY STE 203
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-5559
Mailing Address - Country:US
Mailing Address - Phone:925-436-3155
Mailing Address - Fax:925-350-0156
Practice Address - Street 1:3240 LONE TREE WAY STE 203
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-5559
Practice Address - Country:US
Practice Address - Phone:925-436-3155
Practice Address - Fax:925-350-0156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICALONE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-15
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X, 251G00000X, 261QC1500X, 261QU0200X, 251E00000X, 261QE0700X, 261QH0100X, 251F00000X, 252Y00000X, 251C00000X, 251G00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251F00000XAgenciesHome Infusion
No252Y00000XAgenciesEarly Intervention Provider Agency