St. Rose of Lima Healthcare Provider, Inc.

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

Last updated

Sep 18, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Parivash Asnaashari

Title

Ceo

Phone

(714) 777-5931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417198110. Details of each certification follow.

• CCN 059207 Home health agency · Active · Details

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

Listed as

St. Rose of Lima Healthcare Provider, Inc.CCN 059207 · All quality measures

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

Locations

All disclosed owners & managing parties 2

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

Affiliated clinicians 4

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

• Hamid Eskandari, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Foothill Ranch, CA
  • NPI 1063662682

  Home health agency

  Care Compare affiliation
• Dariush S Lavi, M.D.

  • Internal Medicine Physician
  • Costa Mesa, CA
  • NPI 1750449062

  Home health agency

  Care Compare affiliation
• Alan R. Nili, D.O.

  • Family Medicine Physician
  • Irvine, CA
  • NPI 1356366835

  Home health agency

  Care Compare affiliation
• Ali Tabatabai, M.D.

  • Specialist
  • Laguna Hills, CA
  • NPI 1528098423

  Home health agency

  Care Compare affiliation

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

{
    "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": []
}

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• Home Health Agency in Yorba Linda, CA
• Providers in Yorba Linda, CA by specialty
• Home Health Agency in California

• 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.

Verify at the official NPI Registry.