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Jontia Shallowhorn
Home Health Agency in Moreno Valley, California
NPI 1518518745

Jontia Shallowhorn is a Home Health Agency based in Moreno Valley, CA. Jontia Shallowhorn practices in Moreno Valley, CA. The NPI Number for Jontia Shallowhorn is 1518518745 and holds a License No. B9256240 (California).

The current practice location address for Jontia Shallowhorn is 26929 Nucia Dr, Moreno Valley, CA and can be reached out via phone at 661-492-4743.

Location: 26929 Nucia Dr, Moreno Valley, CA, 92555-4983
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518518745
Provider Name
Jontia Shallowhorn
Credential
Provider Entity Type
Individual
Gender
Female
Address
26929 Nucia Dr, Moreno Valley, CA, 92555-4983
Phone Number
661-492-4743
Fax Number
Provider Enumeration Date
09/29/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B9256240 01 CA CALIFORNIA DRIVER'S LICENSE
institution
Provider Business Practice Location Address Details
Address
26929 Nucia Dr
City
Moreno Valley
State
California
Zip
92555-4983
Phone Number
661-492-4743
Fax Number
person
Provider Business Mailing Address Details
Address
26929 Nucia Dr
City
Moreno Valley
State
California
Zip
92555-4983
Phone Number
661-492-4743
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
251E00000X
License No.
B9256240 (California)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
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