NPIMap

Organization Active NPI

Lake Merritt Healthcare Center LLC

  • Skilled Nursing Facility
  • Monrovia, CA
National Provider Identifier
1801345772
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
020000061 Issued in CA
Legal business name
LAKE MERRITT HEALTHCARE CENTER LLC
Practice address
107 W Lemon Ave
Monrovia, CA 91016-2809
Phone
(626) 658-7344
Fax
(323) 846-5788
NPI assigned
Oct 3, 2016
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Crystal Solorzano
Title
Managing Member
Phone
(323) 836-9397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 020000061 CA Primary

Addresses

Primary practice location

107 W Lemon Ave
Monrovia, CA 91016-2809

Mailing address

309 Macarthur Blvd
Oakland, CA 94610-3233
Phone (510) 836-3777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161122000044 CA Part A Provider - Skilled Nursing Facility 6204115918 Practice locations: Oakland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801345772. Details of each certification follow.

Skilled nursing facility certification: CCN 056350

Legal name
LAKE MERRITT HEALTHCARE CENTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 31, 1972
Last certification
Oct 25, 2024
Beds
53
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Nov 1, 2016
Organization structure
LLCProprietary
Enrollment address
309 Macarthur Blvd
Oakland, CA 94610-3233
Nursing home name
LAKE MERRITT HEALTHCARE CENTER LLC
Affiliated entity
CRYSTAL SOLORZANO

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Merritt Healthcare Center LLCCCN 056350 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 31, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5350.9 residents per day on average
Chain
Crystal Solorzano9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0693043Lake Merritt Healthcare Center LLC309 Macarthur Blvd, Oakland, CA 94610Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Fate Enabulele Individual Operational/Managerial Control Dec 16, 2024
Adp of the SNF Dec 16, 2024
Lmhcst LLC Organization, Chino, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 24, 2024 23.9%
Rachel Ahuva Cohen Individual 5% Or Greater Indirect Ownership Interest Jul 24, 2024 75.34%
Corporate OfficerManager Jul 24, 2024
Operational/Managerial Control Jul 24, 2024
Renew Health Consulting Services LLC Organization, Monrovia, CA LLC, Management services company, Chain home office Operational/Managerial Control Aug 17, 2023
Adp of the SNF Aug 17, 2023
Jaden Rust Individual Indirect Ownership Interest Jul 24, 2024 0.76%
Health Care Partners I LLC Organization, Monrovia, CA LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 24, 2024 76.1%
Paola Dionisio Individual 5% Or Greater Indirect Ownership Interest Jul 24, 2024 23.9%
James M Yeh Individual Operational/Managerial Control Oct 19, 2021
Adp of the SNF Oct 19, 2021
Eva Chavarria Individual Operational/Managerial Control Nov 16, 2024
Adp of the SNF Nov 16, 2024
Vatsala Sharma Individual Operational/Managerial Control Aug 17, 2023
Adp of the SNF Aug 17, 2023
Gateways Rehabilitation Center II LLC Organization, Simi Valley, CA LLC Adp of the SNF Aug 17, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1801345772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MACARTHUR BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946103233",
            "telephone_number": "510-836-3777",
            "fax_number": "510-371-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W LEMON AVE",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910162809",
            "telephone_number": "626-658-7344",
            "fax_number": "323-846-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MERRITT HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "SOLORZANO",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "323-836-9397"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "020000061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

Verify at the official NPI Registry.