Provider Demographics
NPI:1457720617
Name:ADVANCED HOME HEALTH NORTHBAY INC
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH NORTHBAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:HALVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-705-4950
Mailing Address - Street 1:4362 AUBURN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4107
Mailing Address - Country:US
Mailing Address - Phone:925-705-4950
Mailing Address - Fax:925-705-4959
Practice Address - Street 1:2161 YGNACIO VALLEY RD STE 210
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3351
Practice Address - Country:US
Practice Address - Phone:707-643-2100
Practice Address - Fax:707-643-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001265251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550001265OtherHOME HEALTH