Intellicare Services LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INTELLICARE SERVICES LLC

Doing business as

Intellicare Services

Practice address

1630 N Edison St
Stockton, CA 95204-5633

Phone

(209) 406-6610

Fax

(209) 423-8753

NPI assigned

Feb 13, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Gilda D Dizon, RN, BSN

Title

President/Managing Member

Phone

(209) 406-0817

Specialties & licenses 1

Addresses

Other names 1

• INTELLICARE SERVICES Doing business as

Tax ID family

Intellicare Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Intellicare Services LLC

  dba Intellicare Services

  • Case Management Agency
  • Stockton, CA
  • NPI 1235521774
  NPD tax ID

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1760873533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 N EDISON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045633",
            "telephone_number": "209-406-6610",
            "fax_number": "209-423-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 N EDISON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045633",
            "telephone_number": "209-406-6610",
            "fax_number": "209-423-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLICARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "GILDA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/MANAGING MEMBER",
        "authorized_official_telephone_number": "209-406-0817",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTELLICARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ir Supplier LLC
• Tara Jane Iris, RN

• Case Management Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.