Provider Demographics
NPI:1821678038
Name:CARE AYESHA
Entity Type:Organization
Organization Name:CARE AYESHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-899-3831
Mailing Address - Street 1:452 S SWIDLER PL
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4861
Mailing Address - Country:US
Mailing Address - Phone:714-646-6750
Mailing Address - Fax:714-982-3348
Practice Address - Street 1:452 S SWIDLER PL
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4861
Practice Address - Country:US
Practice Address - Phone:714-646-6750
Practice Address - Fax:714-982-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA306005729OtherCCLD