Organization Active NPI

Nurse Haven Home Care Agency LLC

  • In Home Supportive Care Agency
  • Corona, CA
National Provider Identifier
1235887415
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
NURSE HAVEN HOME CARE AGENCY LLC
Practice address
4165 Powell Way Unit 102
Corona, CA 92883-4476
Phone
(714) 702-5905
Fax
(714) 982-3383
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Lisa Wojcik
Title
Owner/Ceo
Phone
(714) 702-5905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

4165 Powell Way Unit 102
Corona, CA 92883-4476

Mailing address

4165 Powell Way Unit 102
Corona, CA 92883-4476
Phone (714) 702-5905

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1235887415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 POWELL WAY UNIT 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834476",
            "telephone_number": "714-702-5905",
            "fax_number": "714-982-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 POWELL WAY UNIT 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928834476",
            "telephone_number": "714-702-5905",
            "fax_number": "714-982-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE HAVEN HOME CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "WOJCIK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "714-702-5905"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.