Provider Demographics
NPI:1780733758
Name:ORACLE HEALTHCARE NETWORK, CORP.
Entity type:Organization
Organization Name:ORACLE HEALTHCARE NETWORK, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:AUDRENE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:925-718-7798
Mailing Address - Street 1:2603 CAMINO RAMON STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-9137
Mailing Address - Country:US
Mailing Address - Phone:925-718-7798
Mailing Address - Fax:925-718-7784
Practice Address - Street 1:2603 CAMINO RAMON STE 200
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-9137
Practice Address - Country:US
Practice Address - Phone:925-718-7798
Practice Address - Fax:925-718-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991615251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107726Medicare ID - Type UnspecifiedPROVIDER NUMBER