Provider Demographics
NPI:1942886171
Name:TRUCARE TELEHEALTH & HOUSE CALLS PRACTICE A PROFESSIONAL NURSING CO
Entity Type:Organization
Organization Name:TRUCARE TELEHEALTH & HOUSE CALLS PRACTICE A PROFESSIONAL NURSING CO
Other - Org Name:TRUCARE TELEHEALTH AND HOUSE CALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEMIKA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:951-405-0444
Mailing Address - Street 1:20709 GOLDEN SPRINGS DR STE 106
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3847
Mailing Address - Country:US
Mailing Address - Phone:951-405-0444
Mailing Address - Fax:951-212-5005
Practice Address - Street 1:20709 GOLDEN SPRINGS DR STE 106
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3847
Practice Address - Country:US
Practice Address - Phone:951-405-0444
Practice Address - Fax:951-212-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty