Covenant Care California, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100000355 Issued in CA

Legal business name

COVENANT CARE CALIFORNIA, LLC

Practice address

9289 Branstetter Place
Stockton, CA 95209-1700

Phone

(209) 477-5252

Fax

(209) 474-0569

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Carol Sparks

Title

Director of Reimbursement

Phone

(949) 349-1200

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wagner Heights Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1801938816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 VANTIS DR STE 200",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562677",
            "telephone_number": "949-349-1200",
            "fax_number": "949-349-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9289 BRANSTETTER PLACE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091700",
            "telephone_number": "209-477-5252",
            "fax_number": "209-474-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT CARE CALIFORNIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "949-349-1200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "100000355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSHPD",
            "identifier": "206394006",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55332H",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wagner Heights Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of San Joaquin
• County of San Joaquin
• Maria Dejesus Covarrubias-Gamino
• Mario Covarrubias
• Covenant Care California, LLC
• Nicole Rane Cowan
• Illa Cox, MSN FNP
• Makayla Cox
• Tomias Cox
• Geert Craenen, MD

• Skilled Nursing Facility in Stockton, CA
• Providers in Stockton, 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 Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.