Provider Demographics
NPI:1851848345
Name:CALIFORNIA STATE HOME HEALTH CARE, LLC.
Entity type:Organization
Organization Name:CALIFORNIA STATE HOME HEALTH CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE PEARL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGORIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-256-0521
Mailing Address - Street 1:270 E 7TH ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-6602
Mailing Address - Country:US
Mailing Address - Phone:951-256-0521
Mailing Address - Fax:
Practice Address - Street 1:270 E. 7TH STREET, STE 1A
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-9480
Practice Address - Country:US
Practice Address - Phone:951-256-0521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health