Vista Pacifica Enterprises Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

250000116 Issued in CA

Legal business name

VISTA PACIFICA ENTERPRISES INC.

Doing business as

Vista Pacifica Convalescent

Practice address

3662 Pacific Ave
Riverside, CA 92509-1948

Phone

(951) 682-4833

Fax

(951) 682-1503

NPI assigned

Jul 21, 2006

Last updated

Oct 28, 2011By 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

Ms. Cheryl B Jumonville

Title

Administrator

Phone

(951) 682-4833

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vista Pacifica Convalescent Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609897222. Details of each certification follow.

• CCN 055361 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 055361

Legal name

VISTA PACIFICA ENTERPRISES INC.

Doing business as

VISTA PACIFICA CONVALESCENT

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 31, 1971

Last certification

Feb 27, 2025

Beds

49

Ownership / control type

Corporation

Multi-facility organization

Vista Pacifica Enterprises, Inc.

Organization structure

CorporationProprietary

Incorporated

Jun 7, 1989 in CA

Enrollment address

3662 Pacific Ave
Jurupa Valley, CA 92509-1948

Nursing home name

VISTA PACIFICA CONVALESCENT HOSPITAL

Listed as

Vista Pacifica Convalescent HospitalCCN 055361 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Dec 31, 1971

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4948.5 residents per day on average

Penalties (3 years)

1Fines totaling $52,611

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Tax ID family

Eucalyptus House6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Eucalyptus House

  • Intellectual Disabilities Intermediate Care Facility
  • Rialto, CA
  • NPI 1689799645
  NPD tax ID
• Gardena House

  • Intellectual Disabilities Intermediate Care Facility
  • Rialto, CA
  • NPI 1013032606
  NPD tax ID
• Holly House

  • Intellectual Disabilities Intermediate Care Facility
  • Rialto, CA
  • NPI 1801911797
  NPD tax ID
• Vista Pacifica Enterprises

  • Skilled Nursing Facility
  • Riverside, CA
  • NPI 1942206305
  NPD tax ID
• Vista Pacifica Enterprises Inc.

  • Skilled Nursing Facility
  • Riverside, CA
  • NPI 1588734164
  NPD tax ID

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 1

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

• Hitesh Chhotabhai Patel, MD

  • Sports Medicine (Family Medicine) Physician
  • Westminster, CA
  • NPI 1902833734

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1609897222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3662 PACIFIC AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925091948",
            "telephone_number": "951-682-4833",
            "fax_number": "951-682-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3662 PACIFIC AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925091948",
            "telephone_number": "951-682-4833",
            "fax_number": "951-682-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PACIFICA ENTERPRISES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "JUMONVILLE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "951-682-4833",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "250000116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250000116",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Pacifica Convalescent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Visiting Nurse Association of the Inland Counties (VNA California)
• Visiting Nurse Association of the Inland Counties (VNA California)
• Vista Behavioral Hospital LLC (Pacific Grove Hospital)
• Vista Pacifica Enterprises
• Vista Pacifica Enterprises Inc.
• Vital Care Health Group a Medical Corporation
• Vital Performance Physical Therapy
• Senia L Vitale, PH.D.
• Vitas Healthcare Corporation of California
• Betsy Vite

• Skilled Nursing Facility in Riverside, CA
• Providers in Riverside, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.