Blossom Valley Home Health Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BLOSSOM VALLEY HOME HEALTH CARE

Practice address

14545 Friar St Ste 199-2
Van Nuys, CA 91411-2397

Phone

(818) 636-0941

NPI assigned

May 6, 2021

Last updated

Sep 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Zhora Julhakyan

Title

Ceo/Cfo/Secretary

Phone

(804) 770-7077

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164006094. Details of each certification follow.

• CCN 758064 Home health agency · Active · Details

Home health agency certification: CCN 758064

Legal name

BLOSSOM VALLEY HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 8, 2025

Last certification

Jul 17, 2025

Organization structure

CorporationProprietary

Enrollment address

14545 Friar St
Ste 199-2
Van Nuys, CA 91411-2397
HHA Branch

Listed as

Blossom Valley Home Health CareCCN 758064 · All quality measures

Ownership

-

Certified

Aug 8, 2025

Medicare certification status

ActiveFrom the Provider of Services file

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": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1164006094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 199-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "804-770-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14545 FRIAR ST STE 199-2",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112397",
            "telephone_number": "818-636-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM VALLEY HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "JULHAKYAN",
        "authorized_official_first_name": "ZHORA",
        "authorized_official_title_or_position": "CEO/CFO/SECRETARY",
        "authorized_official_telephone_number": "804-770-7077"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMR",
            "affiliation": "N",
            "address_1": "14545 Friar St Ste 199-2",
            "city": "Van Nuys",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914112397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.