1. Home
  2. Directory
  3. California
  4. Burbank
  5. Home Health
  6. NPI Profile

PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
NPI 1164429684
Home Health in Burbank, CA

Active since June 30, 2005CLIA 05D0920807 · Waiver
250 E OLIVE AVE STE 202, BURBANK, CA 91502(818) 953-4451(747) 229-2365 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2025, Jan 11, 2023, Dec 1, 2021 and 1 more (4 updates tracked since 2021).

About Providence Health System - Southern California NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA (NPI 1164429684), doing business as Providence Home Health La County North, is a healthcare organization registered as a home health in Burbank, California and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through October 9, 2026 and lists Donald W Anderson, Assistant Secretary For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1164429684
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NamePROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA
Location Address250 E OLIVE AVE STE 202Burbank, CA 91502-1211
Mailing Address250 E Olive Ave Ste 202Burbank, CA 91502-1211 · (818) 953-4451 · Fax (747) 229-2365
Phone(818) 953-4451
Fax(747) 229-2365
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary For Enrollment · (425) 358-9786
Enumeration DateJune 30, 2005
Last NPPES UpdateMay 16, 20254 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1164429684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
License✔ Licensed in CA · 980000499
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.
250 E OLIVE AVE STE 202, Burbank, CA 91502
Open in Google Maps ↗

Other Names 2

Doing Business AsProvidence Home Health La County North
Doing Business AsProvidence Home Care

Other Identifiers 1

MedicaidHHA07627FCA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0920807

Providence Health System - Southern California Dba Providence Home Health La County North · Burbank, CA
Active · expires Oct 9, 2026
CLIA Number05D0920807
Laboratory TypeHome Health Agency
Certificate Effective DateOctober 10, 2024
Certificate Expiration DateOctober 9, 2026
Laboratory DirectorKiho Woo
Laboratory Phone(747) 327-4070
Laboratory LocationProvidence Health System - Southern California Dba Providence Home Health La County North250 E Olive Ave Ste 202, Burbank, CA 91502
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CP LA COUNTY NORTH S-CA HH, LLC
Home Health
250 E OLIVE AVE STE 202
BURBANK, CA 91502
Los Angeles County (818) 953-4451

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health System - Southern California's NPI number?

The NPI number for Providence Health System - Southern California is 1164429684. It was assigned to this organization in the NPPES registry on June 30, 2005. The provider is doing business as Providence Home Health La County North and Providence Home Care.

Where is Providence Health System - Southern California located?

Providence Health System - Southern California is located at 250 E Olive Ave Ste 202, Burbank, CA 91502. The listed phone number is (818) 953-4451.

What is Providence Health System - Southern California's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Providence Health System - Southern California hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0920807) is associated with this NPI, valid through October 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Health System - Southern California was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.