NPIMap

Organization Active NPI

Gerelyn Pediatric Care

  • Intellectual Disabilities Intermediate Care Facility
  • West Covina, CA
National Provider Identifier
1679757595
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
GERELYN PEDIATRIC CARE
Practice address
617 S Sentous Ave
West Covina, CA 91792-3126
Phone
(626) 839-5777
NPI assigned
Dec 27, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Evelyn Pascual
Title
Administrator
Phone
(626) 839-5777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

617 S Sentous Ave
West Covina, CA 91792-3126

Mailing address

617 S Sentous Ave
West Covina, CA 91792-3126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679757595. Details of each certification follow.

  • CCN 55G212 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G212

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GERELYN CARE HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 26, 1998
Last certification
Oct 8, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
617 S Sentous Avenue
West Covina, CA 91792

National Provider Directory

National Provider Directory
Tax ID family
Ge Pediatric Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1679757595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S SENTOUS AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 S SENTOUS AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923126",
            "telephone_number": "626-839-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERELYN PEDIATRIC CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "PASCUAL",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-839-5777"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.