Organization Active NPI

Victorville Home Health

  • Home Health Agency
  • Victorville, CA
National Provider Identifier
1053081240
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
VICTORVILLE HOME HEALTH
Practice address
14360 St Andrews Dr Ste 4a
Victorville, CA 92395-4341
Phone
(800) 613-9590
NPI assigned
Sep 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Vergine Chakhbazian
Title
Ceo
Phone
(800) 613-9590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

14360 St Andrews Dr Ste 4a
Victorville, CA 92395-4341

Mailing address

14360 St Andrews Dr Ste 4a
Victorville, CA 92395-4341
Phone (800) 613-9590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221217000081 CA Part A Provider - Home Health Agency 3678942430 Practice locations: Victorville, CA

Home health agency certification: CCN 757790

Legal name
VICTORVILLE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 21, 2023
Last certification
Nov 15, 2023
Organization structure
CorporationProprietary
Incorporated
Sep 10, 2021 in CA
Enrollment address
14360 St Andrews Dr
Ste 4a
Victorville, CA 92395-4341

Care Compare: Home health agency

Medicare Care Compare
Listed as
Victorville Home HealthCCN 757790 · All quality measures
Ownership
-
Certified
Nov 21, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

14360 St Andrews Dr
Ste 4A
Victorville, CA 92395
Phone (800) 613-9590

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Vergine Chakhbazian Individual 5% Or Greater Direct Ownership InterestCeo/Pres/Cfo/Secr/BM/Owner Sep 10, 2021 100%
Corporate OfficerCeo/Pres/Cfo/Secr/BM/Owner Sep 10, 2021 100%
Corporate DirectorCeo/Pres/Cfo/Secr/BM/Owner Sep 10, 2021 100%
W-2 Managing EmployeeCeo/Pres/Cfo/Secr/BM/Owner Sep 10, 2021 100%

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1053081240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14360 ST ANDREWS DR STE 4A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954341",
            "telephone_number": "800-613-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14360 ST ANDREWS DR STE 4A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954341",
            "telephone_number": "800-613-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORVILLE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "CHAKHBAZIAN",
        "authorized_official_first_name": "VERGINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "800-613-9590"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.