Provider Demographics
NPI:1922463579
Name:NORCAL HOSPICE, INC.
Entity Type:Organization
Organization Name:NORCAL HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FARSHEID
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASSIFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-525-1651
Mailing Address - Street 1:16925 S HARLAN RD STE 303
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8780
Mailing Address - Country:US
Mailing Address - Phone:209-707-3463
Mailing Address - Fax:209-320-7392
Practice Address - Street 1:16925 S HARLAN RD STE 303
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8780
Practice Address - Country:US
Practice Address - Phone:925-525-1651
Practice Address - Fax:209-320-7392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based