Active NPI
Socal Integrated Care, Inc
- Home Health Agency
- Glendale, CA
National Provider Identifier
1689284606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- SOCAL INTEGRATED CARE, INC
- Practice address
- 1220 W Glenoaks Blvd Ste 102
Glendale, CA 91201-2298 - Phone
- (818) 305-5054
- NPI assigned
- Aug 4, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Talin Davoudi, LVN
- Title
- Ceo
- Phone
- (818) 305-5054
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1220 W Glenoaks Blvd Ste 102
Glendale, CA 91201-2298
Mailing address
1220 W Glenoaks Blvd Ste 102
Glendale, CA 91201-2298
Phone (818) 305-5054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200826001510 | CA | Part A Provider - Home Health Agency | 6608293394 | Practice locations: Glendale, CA |
Home health agency certification: CCN 559780
- Legal name
- SOCAL INTEGRATED CARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 18, 2022
- Last certification
- Feb 18, 2022
- Organization structure
- Corporation
- Incorporated
- Jun 30, 2020 in CA
- Enrollment address
- 1220 W Glenoaks Blvd
Ste 102
Glendale, CA 91201-2298
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Socal Integrated Care, Inc
- Overall star rating
- Ownership
- -
- Certified
- Feb 18, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2292337 | Socal Integrated Care, Inc | Certificate of waiver | Oct 23, 2027 |
National Provider Directory
National Provider DirectoryLocations
1220 W Glenoaks Blvd
Ste 102
Glendale, CA 91201
Phone (818) 305-5054
Ownership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Madonnah G Sera | 5% Or Greater Indirect Ownership Interest | Oct 21, 2022 | 14% |
| Corporate Officer | Oct 21, 2022 | 14% | |
| Corporate Director | Oct 21, 2022 | 14% | |
| W-2 Managing Employee | Oct 21, 2022 | 14% | |
| Arlene a Aguit | 5% Or Greater Indirect Ownership Interest | Oct 21, 2022 | 14% |
| Corporate Officer | Oct 21, 2022 | 14% | |
| Corporate Director | Oct 21, 2022 | 14% | |
| W-2 Managing Employee | Oct 21, 2022 | 14% | |
| Narine Zakarian | 5% Or Greater Indirect Ownership Interest | Oct 21, 2022 | 29% |
| Corporate Officer | Oct 21, 2022 | 29% | |
| Corporate Director | Oct 21, 2022 | 29% | |
| W-2 Managing Employee | Oct 21, 2022 | 29% | |
| S.I.C. Group Inc | 5% Or Greater Direct Ownership Interest | Jul 2, 2020 | 100% |
| Talin Davoudi | 5% Or Greater Indirect Ownership Interest | Oct 21, 2022 | 43% |
| W-2 Managing Employee | Feb 1, 2025 |
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": "1596499200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762819200000",
"number": "1689284606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 W GLENOAKS BLVD STE 102",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912012298",
"telephone_number": "818-305-5054",
"fax_number": "818-847-7962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 W GLENOAKS BLVD STE 102",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912012298",
"telephone_number": "818-305-5054"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOCAL INTEGRATED CARE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-04",
"last_updated": "2025-11-11",
"certification_date": "2025-11-11",
"status": "A",
"authorized_official_last_name": "DAVOUDI",
"authorized_official_first_name": "TALIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "818-305-5054",
"authorized_official_credential": "LVN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.