NPIMap

Organization Active NPI

Direct Provider of Healthcare Services, Inc.

  • Home Health Agency
  • Rancho Cucamonga, CA
National Provider Identifier
1003056292
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIRECT PROVIDER OF HEALTHCARE SERVICES, INC.
Practice address
9320 Base Line Rd Ste B
Rancho Cucamonga, CA 91701-5829
Phone
(909) 483-8311
Fax
(909) 483-8382
NPI assigned
Feb 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Panganiban, RN
Title
Chief Executive Officer
Phone
(909) 483-8311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CA Primary

Addresses

Primary practice location

9320 Base Line Rd Ste B
Rancho Cucamonga, CA 91701-5829

Mailing address

9320 Base Line Rd Ste B
Rancho Cucamonga, CA 91701-5829
Phone (909) 483-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090505000430 CA Part A Provider - Home Health Agency 7416005202 Practice locations: Rancho Cucamonga, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003056292. Details of each certification follow.

Home health agency certification: CCN 059415

Legal name
DIRECT PROVIDER OF HEALTHCARE SERVICES, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 28, 2012
Last certification
Apr 22, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 18, 2009 in CA
Enrollment address
9320 Baseline Rd
Ste B
Rancho Cucamonga, CA 91701-5829
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Direct Provider of Healthcare Services, IncCCN 059415 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 28, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1101049Direct Provider of Healthcare Services, Inc9320 Baseline Rd Ste B, Rancho Cucamonga, CA 91701Certificate of waiverJun 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Direct Provider of Healthcare Services Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9320 Base Line Rd
Ste B
Rancho Cucamonga, CA 91701
Phone (909) 483-8311

11801 Pierce St
Fl 2
Riverside, CA 92505
Phone (909) 319-0625

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rodrigo Abayon Panganiban Individual 5% Or Greater Direct Ownership Interest Mar 1, 2023 25%
Corporate OfficerSecretary Mar 1, 2023 25%
Corporate Director Mar 1, 2023
Rodrigo Montoya Panganiban Individual 5% Or Greater Direct Ownership InterestCfo/Vice-President Jan 1, 2015 25%
Corporate OfficerPresident Jan 1, 2015 25%
Corporate DirectorPresident Jan 1, 2015 25%
Susan Abayon Panganiban Individual 5% Or Greater Direct Ownership InterestPresident Mar 1, 2023 50%
Corporate OfficerCeo Mar 1, 2023 50%
Corporate DirectorVice President Mar 1, 2023 50%
W-2 Managing EmployeeAdministrator/DPCS Jul 15, 2011 25%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 21

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1003056292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 BASE LINE RD STE B",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-483-8311",
            "fax_number": "909-483-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 BASE LINE RD STE B",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-483-8311",
            "fax_number": "909-483-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT PROVIDER OF HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "PANGANIBAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-483-8311",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.