1285095299 NPI number — ANX HOME HEALTHCARE NURSING - SANTA CLARA INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285095299 NPI number — ANX HOME HEALTHCARE NURSING - SANTA CLARA INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANX HOME HEALTHCARE NURSING - SANTA CLARA INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285095299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
828 S BASCOM AVE
Provider Second Line Business Mailing Address:
STE 240
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95128-2651
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-271-5721
Provider Business Mailing Address Fax Number:
650-991-5178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 HICKEY BLVD STE 415
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALY CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94015-2630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-271-5721
Provider Business Practice Location Address Fax Number:
650-991-5178
Provider Enumeration Date:
03/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ROCAS
Authorized Official First Name:
THOMAS ALLANDALE
Authorized Official Middle Name:
LAGROSAS
Authorized Official Title or Position:
ADMINISTRATOR / PRESIDENT
Authorized Official Telephone Number:
650-271-5721

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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