Organization Active NPI

St. Rose of Lima Healthcare Provider, Inc.

  • Home Health Agency
  • Yorba Linda, CA
National Provider Identifier
1417198110
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
630011759 Issued in CA
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.

Care Compare: Home health agency

Medicare Care Compare
Listed as
St. Rose of Lima Healthcare Provider, Inc.CCN 059207
Overall star rating
5 of 5
Ownership
Proprietary
Certified
Dec 28, 2009
Medicare certification status
ActiveFrom the Provider of Services file
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
CorporationProprietary
Incorporated
May 11, 2007 in CA
Enrollment address
23361 El Toro Rd
Ste 218a
Lake Forest, CA 92630-6921
HHA Branch

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090320000480 CA Part A Provider - Home Health Agency 5294892139 Practice locations: Lake Forest, CA

All disclosed owners & managing parties 2

Medicare enrollment files

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

NameRoleSinceShare
Rozita Salam Individual W-2 Managing EmployeeRN, Administrator Nov 28, 2018
Parivash Asnaashari Individual 5% Or Greater Direct Ownership Interest May 22, 2018 100%
Corporate OfficerCeo Cfo Secretary Administrator May 26, 2018 100%
Corporate DirectorCeo Cfo Secretary Administrator May 26, 2018 100%

National Provider Directory

National Provider Directory

Locations

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)CodeLicenseStatePrimary
Home Health Agency 251E00000X 630011759 CA Primary

Addresses

NPPES NPI Registry

Primary 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

Verify at the official NPI Registry.