JD Residential Care, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

565802413 Issued in CA

Legal business name

JD RESIDENTIAL CARE, LLC

Practice address

2199 Marvel Ave
Simi Valley, CA 93065-2211

Phone

(805) 791-3461

Fax

(805) 842-1107

NPI assigned

Nov 9, 2017

Organization subpart

No

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

Authorized official

Name

Joji J. Junio

Title

Licensee

Phone

(310) 435-9822

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1801309075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2199 MARVEL AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652211",
            "telephone_number": "805-791-3461",
            "fax_number": "805-842-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2199 MARVEL AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652211",
            "telephone_number": "805-791-3461",
            "fax_number": "805-842-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "JUNIO",
        "authorized_official_first_name": "JOJI",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "310-435-9822"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": "565802413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96035408D",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Aileen Jasso
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• Laura Marie Jen Kin, DDS
• Cherylyn Jensen

• In Home Supportive Care Agency in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.