NPIMap

Organization Active NPI

Jobet Corporation

  • Home Health Agency
  • Simi Valley, CA
National Provider Identifier
1902803752
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
980001394 Issued in CA
Legal business name
JOBET CORPORATION
Practice address
1919 Williams St Ste 310
Simi Valley, CA 93065-7842
Phone
(818) 548-2684
Fax
(818) 548-7384
NPI assigned
Jul 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Ivan Lauritzen, NHA 7607
Title
Administrator
Phone
(818) 548-2684

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 980001394 CA Primary

Addresses

Primary practice location

1919 Williams St Ste 310
Simi Valley, CA 93065-7842

Mailing address

1919 Williams St Ste 310
Simi Valley, CA 93065-7842
Phone (818) 548-2684

Other names 1

  • Dedicated Home Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041113000295 CA Part A Provider - Home Health Agency 1557325156 Practice locations: San Fernando, CA

Home health agency certification: CCN 058153

Legal name
JOBET CORPORATION
Doing business as
DEDICATED HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 16, 2003
Last certification
Feb 28, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 5, 1997 in CA
Enrollment address
601 S Brand Blvd
Ste 312
San Fernando, CA 91340-4040

Care Compare: Home health agency

Medicare Care Compare
Listed as
Dedicated Home Health CareCCN 058153
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jan 16, 2003
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

356A W Colorado St
Glendale, CA 91204

1830 W Olympic Blvd
Ste 211
Los Angeles, CA 90006
Phone (213) 385-1615

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Betty C Deborja Individual W-2 Managing EmployeeDirector of Nursing Aug 28, 2018 100%
Santiago Zamudio Individual Contracted Managing Employee Jan 24, 2002 100%
Ivan V Lauritzen Individual 5% Or Greater Indirect Ownership InterestPresident Aug 28, 2018 100%
Corporate OfficerPresident Aug 28, 2018 100%
W-2 Managing EmployeePresident Aug 28, 2018 100%
Shoreline Health Group Organization, Glendale, CA Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Aug 28, 2018 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1902803752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 WILLIAMS ST STE 310",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657842",
            "telephone_number": "818-548-2684",
            "fax_number": "818-548-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 WILLIAMS ST STE 310",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657842",
            "telephone_number": "818-548-2684",
            "fax_number": "818-548-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOBET CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "LAURITZEN",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-548-2684",
        "authorized_official_credential": "NHA 7607"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dedicated Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.