Provider Demographics
NPI:1679954408
Name:APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.
Entity type:Organization
Organization Name:APPLIED PALLIATIVE AND HOSPICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:VILLANUEVA
Authorized Official - Last Name:DIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-638-8719
Mailing Address - Street 1:2865 SUNRISE BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6538
Mailing Address - Country:US
Mailing Address - Phone:916-638-8719
Mailing Address - Fax:844-273-1326
Practice Address - Street 1:2865 SUNRISE BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6538
Practice Address - Country:US
Practice Address - Phone:916-638-8719
Practice Address - Fax:844-273-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA921535Medicare Oscar/Certification