Organization Active NPI

Lake Forest Hospice

  • Community Based Hospice Care Agency
  • Lake Forest, CA
National Provider Identifier
1174059513
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LAKE FOREST HOSPICE
Practice address
22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303
Phone
(949) 305-0057
NPI assigned
May 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Mr. Serafin G Aguirre
Title
President
Phone
(949) 305-0057

Specialties & licenses 1

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

Addresses

Primary practice location

22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303

Mailing address

22772 Centre Dr Ste 200
Lake Forest, CA 92630-6303
Phone (949) 305-0057

Other names 1

  • LAKE FOREST HOSPICE & PALLATIVE CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170509000937 CA Part A Provider - Hospice 8224315809 Practice locations: Lake Forest, CA

Hospice certification: CCN A01738

Legal name
LAKE FOREST HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 6, 2020
Last certification
Feb 6, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Enrollment address
22772 Centre Dr
Ste 200
Lake Forest, CA 92630-6303

Care Compare: Hospice

Medicare Care Compare
Listed as
Lake Forest HospiceCCN A01738
Ownership
For-Profit
Certified
Feb 6, 2020
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

22772 Centre Dr
Ste 200
Lake Forest, CA 92630
Phone (949) 305-0057

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
Serafin G Aguirre Individual 5% Or Greater Direct Ownership Interest Sep 1, 2024 25%
Corporate OfficerCeo/Administrator Sep 1, 2024 25%
Corporate DirectorCeo/Administrator Sep 1, 2024 25%
W-2 Managing EmployeeCeo/Administrator Sep 1, 2024
Marissa B Cera Individual 5% Or Greater Direct Ownership Interest Sep 1, 2024 25%
Corporate OfficerCorporate Secretary Sep 1, 2024 25%
Corporate DirectorCorporate Secretary Sep 1, 2024 25%
W-2 Managing EmployeeCorporate Secretary Sep 1, 2024 25%
Maria E Ledesma Individual 5% Or Greater Direct Ownership Interest Sep 1, 2024 25%
Corporate OfficerFinance Director Sep 1, 2024 25%
Corporate DirectorFinance Director Sep 1, 2024 25%
W-2 Managing EmployeeFinance Director Sep 1, 2024 25%
Marissa E Tong Individual 5% Or Greater Direct Ownership Interest Sep 1, 2024 25%
Corporate OfficerVP/Marketing Director Sep 1, 2024 25%
Corporate DirectorVP/Marketing Directo Sep 1, 2024 25%
W-2 Managing EmployeeVP/Marketing Directo Sep 1, 2024 25%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1174059513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22772 CENTRE DR STE 200",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306303",
            "telephone_number": "949-305-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22772 CENTRE DR STE 200",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926306303",
            "telephone_number": "949-305-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "SERAFIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-305-0057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE FOREST HOSPICE & PALLATIVE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.