NPIMap

Organization Active NPI

Aveeva Hospice

  • Community Based Hospice Care Agency
  • Riverside, CA
National Provider Identifier
1124575618
Registry record updated Apr 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AVEEVA HOSPICE
Practice address
11860 Magnolia Ave
Suite I
Riverside, CA 92503-4911
Phone
(951) 394-7500
Fax
(951) 394-7501
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jon H Estanislao
Title
Administrator
Phone
(951) 394-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

11860 Magnolia Ave
Suite I
Riverside, CA 92503-4911

Mailing address

PO Box 638
San Dimas, CA 91773-0638
Phone (951) 394-7500

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161018000425 CA Part A Provider - Hospice 0244528677 Practice locations: Riverside, CA

Hospice certification: CCN A01500

Legal name
AVEEVA HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 25, 2018
Last certification
Sep 25, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 1, 2016 in CA
Enrollment address
11860 Magnolia Ave
Ste I
Riverside, CA 92503-4911

Care Compare: Hospice

Medicare Care Compare
Listed as
Aveeva HospiceCCN A01500
Ownership
For-Profit
Certified
Sep 25, 2018
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2128369Aveeva Hospice11860 Magnolia Ave Ste I, Riverside, CA 92503Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory

Locations

11860 Magnolia Ave
Ste I
Riverside, CA 92503
Phone (951) 394-7500

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane Elizabeth Estanislao Individual 5% Or Greater Direct Ownership Interest Apr 15, 2016 50%
Corporate OfficerVice President/Secretary Apr 15, 2016 50%
Corporate DirectorGoverning Board Director Apr 15, 2016 50%
Jon H Estanislao Individual 5% Or Greater Direct Ownership Interest Apr 15, 2016 50%
Corporate OfficerPresident/Treasurer Apr 15, 2016 50%
Corporate DirectorGoverning Board Director Apr 15, 2016 50%
W-2 Managing EmployeeAdministrator Sep 16, 2016
Anna Sabrina Paningbatan Individual W-2 Managing EmployeeDirector of Patient Care Services Feb 1, 2020
Andro N Sharobiem Individual Contracted Managing EmployeeMD; Aug 8, 2016

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777161600000",
    "number": "1124575618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917730638",
            "telephone_number": "951-394-7500",
            "fax_number": "951-394-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11860 MAGNOLIA AVE",
            "address_2": "SUITE I",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034911",
            "telephone_number": "951-394-7500",
            "fax_number": "951-394-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVEEVA HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-04-26",
        "certification_date": "2026-04-26",
        "status": "A",
        "authorized_official_last_name": "ESTANISLAO",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-394-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.