NPIMap

Organization Active NPI

Foothill Care Center II, LLC

  • Adult Care Home Facility
  • Covina, CA
National Provider Identifier
1962624288
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
FOOTHILL CARE CENTER II, LLC
Practice address
5420 N Oakbank Ave
Covina, CA 91722-1936
Phone
(626) 332-8542
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Eden De Asis Salceda
Title
Administrator
Phone
(626) 962-3274

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X CA Primary

Addresses

Primary practice location

5420 N Oakbank Ave
Covina, CA 91722-1936

Mailing address

1758 Big Dalton Ave
Baldwin Park, CA 91706-5910
Phone (626) 962-3274

Other identifiers 1

IdentifierTypeStateIssuer
LTC60619GMedicaidCA

Other names 1

  • Oakbank Home Doing business as

Medicare participation

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

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G796

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
OAKBANK HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 12, 1994
Last certification
Oct 16, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
5420 Oakbank Drive
Covina, CA 91722

National Provider Directory

National Provider Directory
Tax ID family
Foothill Care Center II LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962624288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1758 BIG DALTON AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065910",
            "telephone_number": "626-962-3274",
            "fax_number": "626-962-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 N OAKBANK AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221936",
            "telephone_number": "626-332-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL CARE CENTER II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALCEDA",
        "authorized_official_first_name": "EDEN",
        "authorized_official_middle_name": "DE ASIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-962-3274",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60619G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakbank Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.