NPIMap

Organization Active NPI

A Prime Home Health Services, Inc

  • Home Health Agency
  • Camarillo, CA
National Provider Identifier
1669922183
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
A PRIME HOME HEALTH SERVICES, INC
Practice address
266 Mobil Ave Ste 215
Camarillo, CA 93010-6336
Phone
(877) 332-6755
Fax
(805) 322-7055
NPI assigned
Oct 7, 2016
Last updated
Oct 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Mr. Carl Cadducius Villaluz
Title
Ceo
Phone
(877) 332-6755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

266 Mobil Ave Ste 215
Camarillo, CA 93010-6336

Mailing address

266 Mobil Ave Ste 215
Camarillo, CA 93010-6336
Phone (877) 332-6755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170110003444 CA Part A Provider - Home Health Agency 2668753468 Practice locations: Camarillo, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669922183. Details of each certification follow.

Home health agency certification: CCN 559058

Legal name
A PRIME HOME HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 29, 2019
Last certification
Aug 29, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Aug 2, 2016 in CA
Enrollment address
266 Mobil Ave
Ste 215
Camarillo, CA 93010-6336
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
A Prime Home Health Services IncCCN 559058 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Aug 29, 2019
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
05D2132814A Prime Home Health Services, Inc.266 Mobil Ave Ste 215, Camarillo, CA 93010Certificate of waiverJun 27, 2027

National Provider Directory

National Provider Directory

Locations

266 Mobil Ave
Ste 215
Camarillo, CA 93010
Phone (877) 332-6755

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Carl C Villaluz Individual 5% Or Greater Direct Ownership Interest Aug 2, 2016 60%
Corporate OfficerCeo/Administrator Aug 2, 2016 60%
Corporate DirectorCeo Aug 2, 2016 60%
W-2 Managing EmployeeCeo/Administrator Aug 2, 2016 60%
Ivy Joyce Sagad Individual W-2 Managing EmployeeDirector of Patient Care Services Mar 1, 2021
Christopher a Villaluz Individual 5% Or Greater Direct Ownership InterestChief Operations Officer Jan 1, 2018 40%

Practitioners & affiliated clinicians

Affiliated clinicians 10

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

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1669922183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 MOBIL AVE STE 215",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106336",
            "telephone_number": "877-332-6755",
            "fax_number": "805-322-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 MOBIL AVE STE 215",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106336",
            "telephone_number": "877-332-6755",
            "fax_number": "805-322-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A PRIME HOME HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "VILLALUZ",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "CADDUCIUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-332-6755",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.