Active NPI
St. Rose of Lima Healthcare Provider, Inc.
- Home Health Agency
- Yorba Linda, CA
National Provider Identifier
1417198110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 630011759
- Legal business name
- ST. ROSE OF LIMA HEALTHCARE PROVIDER, INC.
- Practice address
- 4901 Lakeview Ave
Yorba Linda, CA 92886-3473 - Phone
- (714) 777-5931
- Fax
- (714) 695-9882
- NPI assigned
- Mar 10, 2009
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Parivash Asnaashari
- Title
- Ceo
- Phone
- (714) 777-5931
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Foothill Ranch, CA
- NPI 1063662682
Home health agency
Care Compare: Home health agency
Medicare Care Compare- Listed as
- St. Rose of Lima Healthcare Provider, Inc.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 28, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 059207
- Legal name
- ST. ROSE OF LIMA HEALTHCARE PROVIDER, INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 28, 2009
- Last certification
- Nov 19, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- May 11, 2007 in CA
- Enrollment address
- 23361 El Toro Rd
Ste 218a
Lake Forest, CA 92630-6921
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090320000480 | CA | Part A Provider - Home Health Agency | 5294892139 | Practice locations: Lake Forest, CA |
All disclosed owners & managing parties 2
Medicare enrollment filesAs disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Rozita Salam | W-2 Managing Employee | Nov 28, 2018 | |
| Parivash Asnaashari | 5% Or Greater Direct Ownership Interest | May 22, 2018 | 100% |
| Corporate Officer | May 26, 2018 | 100% | |
| Corporate Director | May 26, 2018 | 100% |
National Provider Directory
National Provider DirectoryLocations
23361 El Toro Rd
Ste 218A
Lake Forest, CA 92630
Phone (714) 777-5931
4901 Lakeview Ave
Yorba Linda, CA 92886
Phone (714) 777-5931
18200 Yorba Linda Blvd
Ste 211
Yorba Linda, CA 92886
Phone (714) 777-5931
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 630011759 | CA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
4901 Lakeview Ave
Yorba Linda, CA 92886-3473
Mailing address
23361 El Toro Rd Ste 218a
Lake Forest, CA 92630-6921
Phone (714) 777-5931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 18, 2025.
{
"created_epoch": "1236643200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758153600000",
"number": "1417198110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23361 EL TORO RD STE 218A",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926306921",
"telephone_number": "714-777-5931",
"fax_number": "714-695-9882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 LAKEVIEW AVE",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928863473",
"telephone_number": "714-777-5931",
"fax_number": "714-695-9882"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. ROSE OF LIMA HEALTHCARE PROVIDER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-10",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A",
"authorized_official_last_name": "ASNAASHARI",
"authorized_official_first_name": "PARIVASH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "714-777-5931"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "CA",
"license": "630011759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.