Organization Active NPI

Bella Vista Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Thousand Oaks, CA
National Provider Identifier
1073158770
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BELLA VISTA HOSPICE CARE, INC.
Practice address
889 Pierce CT Ste 103
Thousand Oaks, CA 91360-6098
Phone
(805) 434-6109
Fax
(805) 258-5498
NPI assigned
Nov 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Joni Ruiz, RN
Title
Ceo/Owner
Phone
(805) 434-6109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

889 Pierce CT Ste 103
Thousand Oaks, CA 91360-6098

Mailing address

889 Pierce CT Ste 103
Thousand Oaks, CA 91360-6098
Phone (805) 434-6109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200714001397 CA Part A Provider - Hospice 3375966047 Practice locations: Northridge, CA

Hospice certification: CCN A11648

Legal name
BELLA VISTA HOSPICE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 20, 2020
Last certification
Oct 20, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Sep 25, 2019 in CA
Enrollment address
8700 Reseda Blvd
Ste 205
Northridge, CA 91324-6127

Care Compare: Hospice

Medicare Care Compare
Listed as
Bella Vista Hospice Care, Inc.CCN A11648
Ownership
For-Profit
Certified
Oct 20, 2020
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

8700 Reseda Blvd
Ste 205
Northridge, CA 91324
Phone (818) 812-6545

889 Pierce Ct
Ste 103
Thousand Oaks, CA 91360
Phone (805) 434-6109

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Tae Nam Individual 5% Or Greater Direct Ownership InterestCeo Sep 25, 2019 100%
Roni Eapen Individual W-2 Managing EmployeeDPCS Designee Jan 8, 2020

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1573948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1073158770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 PIERCE CT STE 103",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606098",
            "telephone_number": "805-434-6109",
            "fax_number": "805-258-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 PIERCE CT STE 103",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606098",
            "telephone_number": "805-434-6109",
            "fax_number": "805-258-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA VISTA HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-17",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "JONI",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "805-434-6109",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.