Provider Demographics
NPI:1134665169
Name:D'JANNIC GROUP LLC
Entity type:Organization
Organization Name:D'JANNIC GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONN
Authorized Official - Middle Name:MAHATMA
Authorized Official - Last Name:DMARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-864-6128
Mailing Address - Street 1:7100 STEVENSON BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2485
Mailing Address - Country:US
Mailing Address - Phone:510-398-7494
Mailing Address - Fax:510-398-7495
Practice Address - Street 1:7100 STEVENSON BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2485
Practice Address - Country:US
Practice Address - Phone:510-398-7494
Practice Address - Fax:510-398-7495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-14
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child