NPIMap

Organization Active NPI

Divine Caregivers

  • In Home Supportive Care Agency
  • Stockton, CA
National Provider Identifier
1689828485
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
0900096452 Issued in CA
Legal business name
DIVINE CAREGIVERS
Practice address
9920 Wendt Way
Stockton, CA 95209-4523
Phone
(209) 483-3466
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Gwendolyn Boss
Title
Owner
Phone
(209) 483-3466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 0900096452 CA Primary

Addresses

Primary practice location

9920 Wendt Way
Stockton, CA 95209-4523

Mailing address

9920 Wendt Way
Stockton, CA 95209-4523
Phone (209) 483-3466

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1689828485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 WENDT WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094523",
            "telephone_number": "209-483-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 WENDT WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094523",
            "telephone_number": "209-483-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE CAREGIVERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "BOSS",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-483-3466"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": "0900096452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.