NPIMap

Organization Active NPI

Athome Healthcare Team, LLC

  • Home Health Agency
  • American Canyon, CA
National Provider Identifier
1285043141
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
201420210028 Issued in CA
Legal business name
ATHOME HEALTHCARE TEAM, LLC
Practice address
100 Tower Rd
Suite 15 Mailbox # 8
American Canyon, CA 94503-9650
Phone
(707) 255-4401
NPI assigned
Aug 5, 2014
Last updated
May 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Authorized official

Name
Jennifer Jocson
Title
Administrator
Phone
(707) 255-4401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 201420210028 CA Primary

Addresses

Primary practice location

100 Tower Rd
Suite 15 Mailbox # 8
American Canyon, CA 94503-9650

Mailing address

100 Tower Rd
Suite 15 Mailbox # 8
American Canyon, CA 94503-9650
Phone (707) 255-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150108002374 CA Part A Provider - Home Health Agency 8820311301 Practice locations: American Canyon, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285043141. Details of each certification follow.

Home health agency certification: CCN 059644

Legal name
ATHOME HEALTHCARE TEAM LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 8, 2015
Last certification
Mar 13, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 16, 2014 in CA
Enrollment address
100 Tower Rd
# 15
American Canyon, CA 94503-9650
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Athome Healthcare Team, LLCCCN 059644 · All quality measures
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
May 8, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2091601Athome Healthcare Team LLC100 Tower Rd Ste 15, American Canyon, CA 94503Certificate of waiverFeb 16, 2027

National Provider Directory

National Provider Directory

Locations

100 Tower Rd
#15
American Canyon, CA 94503
Phone (707) 255-4401

100 Tower Rd
Ste 15
American Canyon, CA 94503
Phone (619) 274-1392

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennifer Jocson Individual Corporate OfficerManager/Board Member Aug 16, 2014
W-2 Managing EmployeeAdministrator Aug 16, 2014
Jenalynne de Vera Individual Corporate OfficerManager/Board Member Aug 16, 2014
W-2 Managing EmployeeDirector of Nursing Aug 16, 2014
Marcel Jocson Individual 5% Or Greater Direct Ownership InterestOwner Jul 16, 2014 33.33%
Corporate OfficerVice President Jul 16, 2014
Warden de Vera Individual 5% Or Greater Direct Ownership InterestOwner Jul 16, 2014 33.33%
Corporate OfficerBoard Secretary & Treasurer Jul 16, 2014
Jennivive Venzon Individual Corporate OfficerManager/Board Member Aug 16, 2014
W-2 Managing EmployeeChief Financial Officer Aug 16, 2014
Hamil Venzon Individual 5% Or Greater Direct Ownership InterestOwner Jul 16, 2014 33.34%
Corporate OfficerCeo/President Jul 16, 2014

Practitioners & affiliated clinicians

Affiliated clinicians 18

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1285043141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TOWER RD",
            "address_2": "SUITE 15 MAILBOX # 8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945039650",
            "telephone_number": "707-255-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TOWER RD",
            "address_2": "SUITE 15 MAILBOX # 8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945039650",
            "telephone_number": "707-255-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHOME HEALTHCARE TEAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-05",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "JOCSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-255-4401"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "201420210028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Canyon, CA

Sources for this page

Verify at the official NPI Registry.