Active NPI
Jiaoluan Wang
- In Home Supportive Care Agency
- Riverside, CA
National Provider Identifier
1114813052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 003318344
- Practice address
- 8360 Clover Creek Rd
Riverside, CA 92508-3512 - Phone
- (951) 542-0722
- NPI assigned
- Jun 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 47745 | CA | |
| Personal Care Attendant | 3747P1801X | 003318344 | CA | |
| In Home Supportive Care Agency | 253Z00000X | 003318344 | CA | Primary |
Addresses
Primary practice location
8360 Clover Creek Rd
Riverside, CA 92508-3512
Mailing address
12625 Frederick St Ste E1
Moreno Valley, CA 92553-5253
Phone (951) 542-0722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47745 | CA | MD | General Practice Dentistry |
| 003318344 | CA | MD | In Home Supportive Care Agency |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Holdings, LLC | Massage Therapist | Current | Accepting new patients |
Locations
12625 Frederick St
Ste E1
Moreno Valley, CA 92553
Phone (951) 542-0722
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Moreno Valley, CA
- NPI 1073474532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1114813052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12625 FREDERICK ST STE E1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925535253",
"telephone_number": "951-542-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8360 CLOVER CREEK RD",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925083512",
"telephone_number": "951-542-0722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JIAOLUAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "47745",
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "CA",
"license": "003318344",
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "CA",
"license": "003318344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.