Organization Active NPI

Applied Palliative and Hospice Services, Inc.

  • Community Based Hospice Care Agency
  • Rancho Cordova, CA
National Provider Identifier
1679954408
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.
Practice address
2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538
Phone
(916) 638-8719
Fax
(844) 273-1326
NPI assigned
Jun 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Mrs. Shirley Villanueva Dizon
Title
Ceo
Phone
(916) 638-8719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538

Mailing address

2865 Sunrise Blvd
Suite 103
Rancho Cordova, CA 95742-6538
Phone (916) 638-8719

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150825003752 CA Part A Provider - Hospice 0244546083 Practice locations: Rancho Cordova, CA

Hospice certification: CCN 921535

Legal name
APPLIED PALLIATIVE AND HOSPICE SERVICES INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 19, 2016
Last certification
Aug 23, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 15, 2015 in CA
Enrollment address
2865 Sunrise Blvd 103
Rancho Cordova, CA 95742-6104

Care Compare: Hospice

Medicare Care Compare
Listed as
Applied Palliative and Hospice Services, IncCCN 921535
Ownership
For-Profit
Certified
Oct 19, 2016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

2865 Sunrise Blvd
Ste 103
Rancho Cordova, CA 95742
Phone (916) 638-8719

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Edgardo M Alon Individual Corporate DirectorAdministrator/Director of Patien Jul 11, 2018 100%
Operational/Managerial ControlAdministrator/Director of Patien Jul 11, 2018 100%
Shirley V Dizon Individual 5% Or Greater Direct Ownership InterestOwner Jun 15, 2015 100%
Corporate OfficerCeo Jun 15, 2015 100%
Corporate DirectorCeo/President Jun 15, 2015 100%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1679954408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 SUNRISE BLVD",
            "address_2": "SUITE 103",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957426538",
            "telephone_number": "916-638-8719",
            "fax_number": "844-273-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 SUNRISE BLVD",
            "address_2": "SUITE 103",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957426538",
            "telephone_number": "916-638-8719",
            "fax_number": "844-273-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "VILLANUEVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-638-8719",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.