Angelicum Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550003335 Issued in CA

Legal business name

ANGELICUM HOME HEALTH, INC.

Practice address

3914 Murphy Canyon Rd Ste A166
San Diego, CA 92123-4415

Phone

(858) 495-0400

Fax

(858) 496-9200

NPI assigned

Aug 11, 2014

Organization subpart

No

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

Authorized official

Name

Hazel Ann Asuncion Hernandez

Title

President/Administrator/Ceo

Phone

(858) 495-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 053109

Legal name

ANGELICUM HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 2, 2017

Last certification

Feb 27, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Dec 10, 2013 in CA

Enrollment address

3914 Murphy Canyon Rd
Ste A166
San Diego, CA 92123-4415

Listed as

Angelicum Home Health IncCCN 053109

Overall star rating

2 of 5

Ownership

Proprietary

Certified

May 2, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Locations

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.

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1114336567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 MURPHY CANYON RD STE A166",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234415",
            "telephone_number": "858-495-0400",
            "fax_number": "858-496-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 MURPHY CANYON RD STE A166",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234415",
            "telephone_number": "858-495-0400",
            "fax_number": "858-496-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELICUM HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "HAZEL ANN",
        "authorized_official_middle_name": "ASUNCION",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "858-495-0400"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550003335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C3624597",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emily Angelino
• Mia I Angelino
• Carol Robinson Angell, MFT
• Louise Jeremia Gatchalian Angelo, PHARMD
• Angelplus

• Home Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.