NPIMap

Organization Active NPI

Emanate Health Medical Center

  • Skilled Nursing Facility
  • Covina, CA
National Provider Identifier
1629009097
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EMANATE HEALTH MEDICAL CENTER
Practice address
210 W San Bernardino Rd
Covina, CA 91723-1515
Phone
(626) 331-7331
NPI assigned
Jul 5, 2006
Organization subpart
Yes
Parent organization
EMANATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Roger Sharma
Title
Executive VP/Cfo
Phone
(626) 938-7595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

210 W San Bernardino Rd
Covina, CA 91723-1515

Mailing address

PO Box 840149
Los Angeles, CA 90084-0149
Phone (626) 331-7331

Other identifiers 4

IdentifierTypeStateIssuer
050382OtherCACHAMPUS
ZZC1911ZOtherCABLUE SHIELD CA
002OtherCABLUE CROSS SO CAL
LTC55610FMedicaidCA

Other names 3

  • Citrus Valley Medical Center InterCommunity Skilled Nursing Facility Doing business as
  • Emanate Health Inter-Community Hospital Doing business as
  • Citrus Valley Medical Center Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080313000689 CA Part A Provider - Skilled Nursing Facility 0143317453 Practice locations: Covina, CA

Skilled nursing facility certification: CCN 555610

Legal name
EMANATE HEALTH MEDICAL CENTER
Doing business as
EMANATE HEALTH INTER-COMMUNITY HOSPITAL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 20, 1994
Last certification
May 15, 2025
Beds
25
Ownership / control type
Other Nonprofit
Multi-facility organization
Emanate Health
Organization structure
CorporationNon-profit
Incorporated
Aug 4, 1959 in CA
Enrollment address
210 W San Bernardino Rd
Covina, CA 91723-1515
Nursing home name
EMANATE HEALTH INTER-COMMUNITY HOSPITAL- D/P SNF

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Emanate Health Inter-Community Hospital- D/P SNFCCN 555610
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Oct 20, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2518.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Citrus Valley Medical Center Inc2 organizations share this tax ID, including this one
Part of
Citrus Valley Health Partners

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Melissa Howard Individual Corporate DirectorChief Nurse & Clinical Executive Jan 1, 2017
Operational/Managerial Control Jan 1, 2017
Adp of the SNF Jan 1, 2017
Walter Allen Individual Corporate DirectorBoard Member Jun 1, 2024
Gary Mathewson Individual Corporate DirectorBoard Member Feb 19, 2008
Sanjay Natverlal Khedia Individual Corporate DirectorBoard Member Sep 1, 2023
Raffaele M Corbisiero Individual Corporate DirectorBoard Member Jan 1, 2024
Thomas O. Bryan Individual Corporate OfficerBoard Member Jun 1, 2024
Corporate DirectorBoard Member Jun 1, 2024
Clifford Charles Christ Individual Corporate DirectorBoard Member Feb 19, 2008
Rajesh K Sharma Individual Corporate OfficerPresident/Ceo Apr 2, 2022 100%
Operational/Managerial Control Apr 2, 2022
Lisa Fuerst Individual Corporate OfficerBoard Member Jan 1, 2019
Philip B Maldonado Individual Corporate DirectorBoard Member Jun 1, 2023
Patsy Gorrell Individual Corporate OfficerBoard Member Apr 1, 2018
Corporate DirectorBoard Member Apr 1, 2018
Mary Kirchen Individual Corporate DirectorBoard Member Feb 19, 2008
Emanate Health Organization, Covina, CA Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 15, 2018 100%
Adp of the SNF May 6, 2026
Sharon Juliana Yee Individual Corporate DirectorBoard Member Jun 1, 2016
Mojtaba Moghadam Individual Corporate Director Jan 1, 1993
Operational/Managerial Control Jan 1, 1993
Adp of the SNF Jan 1, 1993
Lucrecia Montes Individual Corporate Director Jun 1, 2022
Brenda N Hayakawa Individual Corporate OfficerBoard Member Jan 1, 2024
Robert Gonzales Individual Corporate OfficerBoard Member Jan 1, 2023
Eddie Arvayo Individual Operational/Managerial Control Feb 1, 2023

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1629009097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840149",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840149",
            "telephone_number": "626-331-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-331-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMANATE HEALTH",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "626-938-7595"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "050382",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CA",
            "identifier": "ZZC1911Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SO CAL",
            "identifier": "002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55610F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Valley Medical Center InterCommunity Skilled Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emanate Health Inter-Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Citrus Valley Medical Center Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Citrus Valley Medical Center Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.