Provider Demographics
NPI: | 1932365293 |
---|---|
Name: | MEDICALONE HEALTH |
Entity Type: | Organization |
Organization Name: | MEDICALONE HEALTH |
Other - Org Name: | MEDICALONE HOME HEALTH |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | CEO/ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VICTORIA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NWOKOCHAH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 925-436-3155 |
Mailing Address - Street 1: | 3012 LONE TREE WAY STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | ANTIOCH |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94509-4933 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 925-436-3155 |
Mailing Address - Fax: | 925-350-0156 |
Practice Address - Street 1: | 3012 LONE TREE WAY STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | ANTIOCH |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94509-4933 |
Practice Address - Country: | US |
Practice Address - Phone: | 925-436-3155 |
Practice Address - Fax: | 925-350-0156 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | MEDICALONE HEALTH |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2008-08-05 |
Last Update Date: | 2023-01-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | ||
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 164X00000X | Nursing Service Providers | Licensed Vocational Nurse | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 251G00000X | Agencies | Hospice Care, Community Based | ||
No | 251J00000X | Agencies | Nursing Care | ||
No | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty |