Organization Active NPI

Family Care Hospice & Home Health, Inc.

  • Home Health Registered Nurse
  • Santa Ana, CA
National Provider Identifier
1114794138
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
Legal business name
FAMILY CARE HOSPICE & HOME HEALTH, INC.
Practice address
1415 E 17TH St Ste 220E
Santa Ana, CA 92705-8525
Phone
(714) 499-1701
Fax
(888) 365-4466
NPI assigned
Dec 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Authorized official

Name
Wilmer A Hernandez
Title
Authorized Official
Phone
(714) 499-1701

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X
Home Health Registered Nurse 163WH0200X Primary
Home Health Agency 251E00000X
Community Based Hospice Care Agency 251G00000X
Early Intervention Provider Agency 252Y00000X
In Home Supportive Care Agency 253Z00000X
Preferred Provider Organization 305R00000X
Customized Equipment (DME) 332BC3200X
Dialysis Equipment & Supplies (DME) 332BD1200X
Oxygen Equipment & Supplies (DME) 332BX2000X
Long Term Care Pharmacy 3336L0003X
Non-emergency Medical Transport (VAN) 343900000X
Physician Assistant 363A00000X
Respite Care 385H00000X
Prevention Professional 405300000X

Addresses

Primary practice location

1415 E 17TH St Ste 220E
Santa Ana, CA 92705-8525

Mailing address

1415 E 17TH St Ste 220E
Santa Ana, CA 92705-8525
Phone (714) 395-8502

Other identifiers 2

IdentifierTypeStateIssuer
1225805245MedicaidCA
1558138362MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Family Care Hospice Home Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1114794138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E 17TH ST STE 220E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058525",
            "telephone_number": "714-395-8502",
            "fax_number": "888-365-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E 17TH ST STE 220E",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927058525",
            "telephone_number": "714-499-1701",
            "fax_number": "888-365-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE HOSPICE & HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "WILMER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "714-499-1701"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225805245",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558138362",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.