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Organization Active NPI

Sierra Home Healthcare Services, Inc.

  • Home Health Agency
  • Los Angeles, CA
National Provider Identifier
1699742601
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001494 Issued in CA
Legal business name
SIERRA HOME HEALTHCARE SERVICES, INC.
Practice address
3660 Wilshire Blvd
Suite 614
Los Angeles, CA 90010-2719
Phone
(213) 386-1235
Fax
(213) 386-1223
NPI assigned
Mar 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Mr. Jeong W Han
Title
Administrator
Phone
(213) 386-1235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001494 CA Primary

Addresses

Primary practice location

3660 Wilshire Blvd
Suite 614
Los Angeles, CA 90010-2719

Mailing address

3660 Wilshire Blvd
Suite 614
Los Angeles, CA 90010-2751
Phone (213) 386-1235

Other identifiers 1

IdentifierTypeStateIssuer
HHA58242FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030313000007 CA Part A Provider - Home Health Agency 3971412206 Practice locations: Los Angeles, CA

Home health agency certification: CCN 058242

Legal name
SIERRA HOME HEALTHCARE SERVICES, INC.
Doing business as
PRL HOME CARE CONSULTING INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 8, 2004
Last certification
Dec 17, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
2064 Marengo St
# 400
Los Angeles, CA 90033-1353

Care Compare: Home health agency

Medicare Care Compare
Listed as
Sierra Home Healthcare Services, IncCCN 058242 ยท All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Jan 8, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

2064 Marengo St
#400
Los Angeles, CA 90033
Phone (323) 222-1235

3660 Wilshire Blvd
Ste 614
Los Angeles, CA 90010
Phone (213) 386-1235

3660 Wilshire Blvd
Ste 820
Los Angeles, CA 90010
Phone (213) 386-1235

2064 Marengo St
Los Angeles, CA 90033
Phone (323) 222-1235

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
Jeong W Han Individual Corporate OfficerAdministrator, Corporate Secretary Apr 9, 2002
W-2 Managing EmployeeAd;Corporate Secretary Apr 9, 2002
Operational/Managerial ControlAdministrator, Corporate Secretary Apr 9, 2002
Manami Toyooka Individual Corporate DirectorDirector of Patient Care Service May 18, 2021
W-2 Managing EmployeeDirector of Patient Care Services` May 18, 2021
Operational/Managerial ControlDirector of Patient Care Service May 18, 2021
Young Y Park Individual 5% Or Greater Direct Ownership InterestCeo Apr 9, 2002 100%
Corporate OfficerCeo Apr 9, 2002 100%
Corporate DirectorCeo Apr 9, 2002 100%
Operational/Managerial ControlCeo Apr 9, 2004 100%

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1699742601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 WILSHIRE BLVD",
            "address_2": "SUITE 614",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102751",
            "telephone_number": "213-386-1235",
            "fax_number": "213-386-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 WILSHIRE BLVD",
            "address_2": "SUITE 614",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102719",
            "telephone_number": "213-386-1235",
            "fax_number": "213-386-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA HOME HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "JEONG",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-386-1235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA58242F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.