Organization Active NPI

Odos Home Health, Inc

  • Home Health Agency
  • La Mesa, CA
National Provider Identifier
1033413182
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ODOS HOME HEALTH, INC
Practice address
7840 El Cajon Blvd Ste 500
La Mesa, CA 91942-0620
Phone
(858) 362-1637
Fax
(858) 433-4494
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Ceferino Fajardo
Title
Administrator
Phone
(858) 362-1637

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

7840 El Cajon Blvd Ste 500
La Mesa, CA 91942-0620

Mailing address

7840 El Cajon Blvd Ste 500
La Mesa, CA 91942-0620
Phone (858) 362-1637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110602000741 CA Part A Provider - Home Health Agency 2466639240 Practice locations: La Mesa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033413182. Details of each certification follow.

Home health agency certification: CCN 059374

Legal name
ODOS HOME HEALTH, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 14, 2012
Last certification
Mar 2, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 9, 2010 in CA
Enrollment address
7840 El Cajon Blvd
Ste 500
La Mesa, CA 91942-0620

Care Compare: Home health agency

Medicare Care Compare
Listed as
Odos Home Health IncCCN 059374 · All quality measures
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Mar 14, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

7840 El Cajon Blvd
Ste 500
La Mesa, CA 91942
Phone (858) 362-1637

9225 Dowdy Dr
Ste 218
San Diego, CA 92126

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Ceferino M Fajardo, Jr. Individual 5% Or Greater Direct Ownership InterestPresident/Administrator May 12, 2011 100%
Analie Duran Individual W-2 Managing Employee May 12, 2011
John a Berger Individual Corporate DirectorMedical Director Mar 1, 2013
Maria Fajardo Individual W-2 Managing EmployeeHR Manager May 12, 2012

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1033413182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7840 EL CAJON BLVD STE 500",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420620",
            "telephone_number": "858-362-1637",
            "fax_number": "858-433-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 EL CAJON BLVD STE 500",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420620",
            "telephone_number": "858-362-1637",
            "fax_number": "858-433-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODOS HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "CEFERINO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "858-362-1637"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.