Organization
PROVIDENT HOME HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUZ M LATUS (ADMINISTRATOR/ DPCS)
(858) 530-0442
Entity
Organization
Contact information
Practice address
7950 SILVERTON AVE, SUITE 114, SAN DIEGO, CA 92126-6342
(858) 530-0442
(858) 530-0545
Mailing address
7950 SILVERTON AVE, SUITE 114, SAN DIEGO, CA 92126-6342
(858) 530-0442
(858) 530-0545
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
175530
CA
Other
Enumeration date
01/12/2009
Last updated
10/30/2019
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