Organization Active NPI

St Joseph Health System Home Health Agency LLC

Doing business as Providence Home Health Orange County

  • Home Health Agency
  • Anaheim, CA
National Provider Identifier
1730162579
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
060000277 Issued in CA
Legal business name
ST JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY LLC
Doing business as
Providence Home Health Orange County
Practice address
200 W Center Street Promenade Ste 200C
Anaheim, CA 92805-3960
Phone
(714) 712-9500
NPI assigned
Nov 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secretary for Enrollment
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 060000277 CA Primary

Addresses

Primary practice location

200 W Center Street Promenade Ste 200C
Anaheim, CA 92805-3960

Mailing address

P.O. Box 31001-1956
Commercial Pay Lockbox
Pasadena, CA 91110-1956
Phone (714) 712-9500

Other identifiers 1

IdentifierTypeStateIssuer
330155323OtherCAMEDI-CAL

Other names 1

  • Providence Home Health Orange County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

200 W Ctr St Promenade
#200C
Anaheim, CA 92805
Phone (714) 712-9500

200 W Ctr St Promenade
Ste 200C
Anaheim, CA 92805
Phone (657) 640-8090

27285 Las Ramblas
Ste 120
Mission Viejo, CA 92691

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Sep 29, 2025 Change of OwnershipThis provider was the seller Providence at Home With Compassus Home Health, Orange CountyCCN 057600, CA, NPI 1588486716

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1730162579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 31001-1956",
            "address_2": "COMMERCIAL PAY LOCKBOX",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911101956",
            "telephone_number": "714-712-9500",
            "fax_number": "714-712-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CENTER STREET PROMENADE STE 200C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053960",
            "telephone_number": "714-712-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-25",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY FOR ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "060000277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "330155323",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Home Health Orange County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.