Provider Demographics
NPI:1669058558
Name:OMATOCHI CORP
Entity type:Organization
Organization Name:OMATOCHI CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NJIDEKA
Authorized Official - Middle Name:HILDA
Authorized Official - Last Name:DIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-346-5593
Mailing Address - Street 1:22454 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3118
Mailing Address - Country:US
Mailing Address - Phone:209-346-5593
Mailing Address - Fax:
Practice Address - Street 1:6500 DUBLIN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-3152
Practice Address - Country:US
Practice Address - Phone:925-905-1662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care