Active NPI
Great Valley Home Health LLC
Doing business as Great Valley Home Health
- Home Health Agency
- Tracy, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- GREAT VALLEY HOME HEALTH LLC
- Doing business as
- Great Valley Home Health
- Practice address
- 2730 Naglee Rd Ste 200
Tracy, CA 95304-7309 - Phone
- (209) 229-8454
- NPI assigned
- Oct 16, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ferdinand Lee
- Title
- President
- Phone
- (209) 229-8454
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
2730 Naglee Rd Ste 200
Tracy, CA 95304-7309
Mailing address
2730 Naglee Rd Ste 200
Tracy, CA 95304-7309
Phone (209) 229-8454
Other names 1
- GREAT VALLEY HOME HEALTH
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200206000111 | CA | Part A Provider - Home Health Agency | 7618303868 | Practice locations: Tracy, CA |
Home health agency certification: CCN 559260
- Legal name
- GREAT VALLEY HOME HEALTH LLC
- Doing business as
- GREAT VALLEY HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 8, 2020
- Last certification
- Dec 8, 2020
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Enrollment address
- 2730 Naglee Rd
Ste 200
Tracy, CA 95304-7309
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Great Valley Home Health
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 8, 2020
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2181717 | Great Valley Home Health LLC | Certificate of waiver | Apr 8, 2028 |
National Provider Directory
National Provider DirectoryLocations
2730 Naglee Rd
#200
Tracy, CA 95304
Phone (209) 229-8454
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Noreen Fajardo | 5% Or Greater Direct Ownership Interest | Oct 1, 2025 | 50% |
| Corporate Officer | Oct 1, 2025 | 50% | |
| Corporate Director | Oct 1, 2025 | 50% | |
| W-2 Managing Employee | Oct 1, 2025 | 50% | |
| Ferdinand Lee | 5% Or Greater Direct Ownership Interest | Oct 1, 2025 | 50% |
| Corporate Officer | Oct 1, 2025 | 50% | |
| Corporate Director | Oct 1, 2025 | 50% | |
| W-2 Managing Employee | Oct 1, 2025 | 50% |
Practitioners & affiliated clinicians
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Travis Afb, CA
- NPI 1629310743
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1763596800000",
"number": "1902448368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 NAGLEE RD STE 200",
"city": "TRACY",
"state": "CA",
"postal_code": "953047309",
"telephone_number": "209-229-8454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2730 NAGLEE RD STE 200",
"city": "TRACY",
"state": "CA",
"postal_code": "953047309",
"telephone_number": "209-229-8454"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT VALLEY HOME HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-16",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "FERDINAND",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "209-229-8454",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "GREAT VALLEY HOME HEALTH",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.