Davina Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

DAVINA HOME CARE LLC

Practice address

13612 Kings Canyon CT
Fontana, CA 92336-3804

Phone

(909) 434-2162

NPI assigned

May 16, 2022

Organization subpart

No

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

Authorized official

Name

Miracle Robert

Title

Owner/President

Phone

(909) 434-2162

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1972240679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13612 KINGS CANYON CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363804",
            "telephone_number": "909-434-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13612 KINGS CANYON CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923363804",
            "telephone_number": "909-434-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVINA HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "ROBERT",
        "authorized_official_first_name": "MIRACLE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "909-434-2162"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rouzbeh Darvishan
• Vinod K. Dasika, MD
• Richard Javid Dass, NP
• Kevin Dator
• Gary Steven Davey, P.T.
• Antoine Davis
• Asheion Kenyoni Lee Davis, RRT-RCP
• Jeffrey A. Davis, MD
• Veronica Davis, CRNA
• Aiyana Davison, CNM

• In Home Supportive Care Agency in Fontana, CA
• Providers in Fontana, 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 May 16, 2022; 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.