Provider Demographics
NPI:1912051244
Name:VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF THE INLAND COUNTIES
Other - Org Name:VNA CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJNIT
Authorized Official - Middle Name:
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-413-1200
Mailing Address - Street 1:6235 RIVER CREST DR STE L
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0758
Mailing Address - Country:US
Mailing Address - Phone:951-413-1200
Mailing Address - Fax:951-413-1208
Practice Address - Street 1:6235 RIVER CREST DR
Practice Address - Street 2:SUITE L
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0788
Practice Address - Country:US
Practice Address - Phone:951-413-1200
Practice Address - Fax:951-413-1208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250000025251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03704ZOtherBLUE SHIELD HOS PROV #
CAHPC01602FMedicaid
CA051602Medicare ID - Type UnspecifiedMEDICARE HOSPICE PROV. #