Organization Active NPI

Socal Integrated Care, Inc

  • Home Health Agency
  • Glendale, CA
National Provider Identifier
1689284606
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Nov 11, 2025

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
CorporationProprietary
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, IncCCN 559780
Overall star rating
4 of 5
Ownership
-
Certified
Feb 18, 2022
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2292337Socal Integrated Care, Inc1220 W Glenoaks Blvd Ste 102, Glendale, CA 91201Certificate of waiverOct 23, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Madonnah G Sera Individual 5% Or Greater Indirect Ownership Interest Oct 21, 2022 14%
Corporate OfficerAdministrator and Director of PA Oct 21, 2022 14%
Corporate DirectorAdministrator and Director of PA Oct 21, 2022 14%
W-2 Managing EmployeeAdministrator and Director of PA Oct 21, 2022 14%
Arlene a Aguit Individual 5% Or Greater Indirect Ownership Interest Oct 21, 2022 14%
Corporate OfficerSecretary Oct 21, 2022 14%
Corporate DirectorSecretary Oct 21, 2022 14%
W-2 Managing EmployeeSecretary Oct 21, 2022 14%
Narine Zakarian Individual 5% Or Greater Indirect Ownership Interest Oct 21, 2022 29%
Corporate OfficerCfo Oct 21, 2022 29%
Corporate DirectorCfo Oct 21, 2022 29%
W-2 Managing EmployeeCeo Oct 21, 2022 29%
S.I.C. Group Inc Organization, Glendale, CA Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Jul 2, 2020 100%
Talin Davoudi Individual 5% Or Greater Indirect Ownership Interest Oct 21, 2022 43%
W-2 Managing EmployeeCeo 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

Verify at the official NPI Registry.